Avital Malka Wolf-Prusan

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT112841 Issued in CA

Practice address

459 Fulton St Ste 106
San Francisco, CA 94102-4364

Phone

(415) 658-5364

NPI assigned

Aug 31, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

University of California, San Francisco School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bay Area Therapy Group a Marriage Family Counseling CorpGroup PAC ID 4789182593, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Bay Area Therapy Group a Marriage Family Counseling Corp

  • Mental Health Counselor
  • Concord, CA
  • NPI 1861085672
  Medicare reassignment Care Compare group

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705449600000",
    "number": "1457807232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 11TH AVE",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941222205",
            "telephone_number": "415-412-2747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "459 FULTON ST STE 106",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941024364",
            "telephone_number": "415-658-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLF-PRUSAN",
        "first_name": "AVITAL",
        "middle_name": "MALKA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-31",
        "last_updated": "2024-01-17",
        "certification_date": "2024-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT112841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julianne Christine Wojciak, M.S.
• Sasha Wojcik
• Alexander Wold
• Aden Tekie Woldemariam, BSW
• Alana Wolens
• Alexander John Wolf, MD
• Alisa Jane Wolf
• Eugene M. Wolf, M. D.
• Jaclyn Wolf, PH.D.
• Jeffrey L. Wolf, M.D.

• Marriage & Family Therapist in San Francisco, CA
• Providers in San Francisco, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.