Individual provider Active NPI

Amy Elizabeth Harper

  • Marriage & Family Therapist
  • Mariposa, CA
National Provider Identifier
1467704189
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110473 Issued in CA
Practice address
5079 Highway 140
Mariposa, CA 95338-2434
Phone
(209) 742-5080
NPI assigned
Oct 4, 2012
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 110473 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

5079 Highway 140
Mariposa, CA 95338-2434

Mailing address

4110 Oak Grove Rd
Mariposa, CA 95338-9200
Phone (209) 742-5080

Other practice location 1

744 San Antonio Rd
Suite 22
Palo Alto, CA 94303-4632
Phone (650) 493-5006 ext. 774

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20241218000905 CA Practitioner - Marriage and Family Therapist 1355878166 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110473CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Counseling CurrentSince Jan 7, 2024 Accepting new patients
Evergreen Marriage and Family Counseling Services, Corp. Marriage & Family Therapist CurrentSince Sep 24, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1467704189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 OAK GROVE RD",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953389200",
            "telephone_number": "209-742-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5079 HIGHWAY 140",
            "city": "MARIPOSA",
            "state": "CA",
            "postal_code": "953382434",
            "telephone_number": "209-742-5080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 San Antonio Rd",
            "address_2": "Suite 22",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943034632",
            "country_code": "US",
            "telephone_number": "650-493-5006 x774",
            "fax_number": "650-493-6835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARPER",
        "first_name": "AMY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-04",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110473",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mariposa, CA

Sources for this page

Verify at the official NPI Registry.