Jacky Guan

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

138984 Issued in CA

Practice address

310 Harbor Blvd BLDG E
Belmont, CA 94002-4018

Phone

(510) 815-9748

NPI assigned

May 30, 2018

Last updated

Jan 31, 2025By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• County of San Mateo

  dba Shasta

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1528432481
  NPD
• County of San Mateo

  dba San Mateo Medical Center

  • Multi-Specialty Clinic/Center
  • San Mateo, CA
  • NPI 1679642326
  NPD
• San Mateo County

  dba South County Mental Health

  • Community/Behavioral Health Agency
  • Redwood City, CA
  • NPI 1912926692

  Mental Health

  NPD

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738281600000",
    "number": "1487146197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 HARBOR BLVD BLDG E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024018",
            "telephone_number": "510-815-9748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 HARBOR BLVD BLDG E",
            "city": "BELMONT",
            "state": "CA",
            "postal_code": "940024018",
            "telephone_number": "510-815-9748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUAN",
        "first_name": "JACKY",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-30",
        "last_updated": "2025-01-31",
        "certification_date": "2025-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138984",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Suzanne Gorney, PHD
• Grains of Good Foundation
• Donald Green
• Gary A Greensweig, D.O.
• Jennifer Amanda Gross, LMFT/LPCC
• Jian an Guo
• Shika Gupta
• Joseph Atteberry Gutierez
• Mario Skiles Gutierrez, D.C.
• Melinda Susan Halden, OTR/L

• Marriage & Family Therapist in Belmont, CA
• Providers in Belmont, 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 31, 2025; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.