Individual provider Active NPI

Jennifer Lynne Randt

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1487194627
Registry record updated Aug 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125941 Issued in CA
Practice address
3036 Regent St
Berkeley, CA 94705-2551
Phone
(650) 219-5689
NPI assigned
Mar 7, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2021

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 125941 CA Primary

Addresses

Primary practice location

3036 Regent St
Berkeley, CA 94705-2551

Mailing address

934 56TH St
Oakland, CA 94608-3124
Phone (650) 219-5689

Other practice location 1

2501 Harrison St
Oakland, CA 94612-3811
Phone (510) 444-3344 ext. 2222

Other practice location 2

6536 Telegraph Ave Ste C102
Oakland, CA 94609-1398
Phone (510) 496-6002 ext. 4

Other practice location 3

13925 San Pablo Ave Ste 203
San Pablo, CA 94806-3676
Phone (510) 778-8114

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
125941CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Oakland Counseling Center PastSince Nov 24, 2019 Accepting new patients
John F. Kennedy University Marriage & Family Therapist Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1488844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1487194627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "934 56TH ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946083124",
            "telephone_number": "650-219-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3036 REGENT ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052551",
            "telephone_number": "650-219-5689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946123811",
            "country_code": "US",
            "telephone_number": "510-444-3344 x2222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6536 Telegraph Ave Ste C102",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946091398",
            "country_code": "US",
            "telephone_number": "510-496-6002 x4",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13925 San Pablo Ave Ste 203",
            "address_purpose": "LOCATION",
            "city": "San Pablo",
            "state": "CA",
            "postal_code": "948063676",
            "country_code": "US",
            "telephone_number": "510-778-8114",
            "fax_number": "510-778-8255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RANDT",
        "first_name": "JENNIFER",
        "middle_name": "LYNNE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-07",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; 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.