Individual provider Active NPI

Devon D'Avanzo

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1497257349
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT151638 Issued in CA
Practice address
2300 Martin Luther King Jr Way
Berkeley, CA 94704-1412
Phone
(415) 617-9806
NPI assigned
Mar 7, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT110602 CA
Behavior Technician 106S00000X RBT-17-32057
Marriage & Family Therapist 106H00000X LMFT151638 CA Primary

Addresses

Primary practice location

2300 Martin Luther King Jr Way
Berkeley, CA 94704-1412

Mailing address

13925 San Pablo Ave Ste 208
San Pablo, CA 94806-3676
Phone (415) 456-7724

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
AMFT110602CAMDMarriage & Family Therapist
LMFT151638CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Child Therapy Institute of Marin CurrentSince Jan 26, 2025 Accepting new patients
Steps Therapy Inc Past Accepting new patients

Locations

2300 Martin Luther King Jr Way
Berkeley, CA 94704
Phone (415) 617-9806

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": "1520380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1497257349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13925 SAN PABLO AVE STE 208",
            "city": "SAN PABLO",
            "state": "CA",
            "postal_code": "948063676",
            "telephone_number": "415-456-7724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 MARTIN LUTHER KING JR WAY",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041412",
            "telephone_number": "415-617-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AVANZO",
        "first_name": "DEVON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-07",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT110602",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": "RBT-17-32057",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT151638",
            "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 Jan 23, 2025; 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.