Individual provider Active NPI

Mira Patel

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1477097632
Registry record updated Dec 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94031 Issued in CA
Practice address
2680 S White Rd
San Jose, CA 95148-2074
Phone
(408) 755-3905
NPI assigned
Dec 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 94031 CA Primary

Addresses

Primary practice location

2680 S White Rd
San Jose, CA 95148-2074

Mailing address

PO Box 816
Mountain View, CA 94042-0816
Phone (650) 996-2214

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

LicenseStateTypeSpecialty
94031CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1481068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481068800000",
    "number": "1477097632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 816",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940420816",
            "telephone_number": "650-996-2214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2680 S WHITE RD",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951482074",
            "telephone_number": "408-755-3905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "MIRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-07",
        "last_updated": "2016-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.