Active NPI
Jose G Ponssa, IMF
- Marriage & Family Therapist
- Hayward, CA
National Provider Identifier
1407064702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 44884
- Practice address
- 29800 Mission Blvd
Hayward, CA 94544-6726 - Phone
- (510) 471-5880
- Fax
- (510) 690-9065
- NPI assigned
- May 18, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 44884 | CA | Primary |
Addresses
Primary practice location
29800 Mission Blvd
Hayward, CA 94544-6726
Mailing address
22331 Mission Blvd
Hayward, CA 94541-3911
Phone (510) 471-5907
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44884 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tiburcio Vasquez Health Center.Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Case Management Agency
- Hayward, CA
- NPI 1689821688
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407064702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22331 MISSION BLVD",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945413911",
"telephone_number": "510-471-5907",
"fax_number": "510-690-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "29800 MISSION BLVD",
"city": "HAYWARD",
"state": "CA",
"postal_code": "945446726",
"telephone_number": "510-471-5880",
"fax_number": "510-690-9065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PONSSA",
"first_name": "JOSE",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "IMF",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "44884",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hayward, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.