Edna Avraham, MFT

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

License

MA20840 Issued in CA

Practice address

205 E 3Rd Ave Ste 308
San Mateo, CA 94401-4052

Phone

(650) 579-7153

NPI assigned

Aug 30, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630281600000",
    "number": "1497422190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "347 CASTILIAN WAY",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944022325",
            "telephone_number": "650-773-2460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E 3RD AVE STE 308",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944014052",
            "telephone_number": "650-579-7153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVRAHAM",
        "first_name": "EDNA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-30",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "CA",
            "license": "MA20840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.EdnaAvraham.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Text",
            "address_1": "205 E 3rd Ave Ste 308",
            "city": "San Mateo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "944014052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Suleyma Avila Favoreno
• Adriana Cabezas Avila
• Angela Avila
• Lianne Carolyn Avila, M.A.
• Marcela Stephanie Avina
• Swati Awsare, M.D.
• Gennesis Sharai Ayala
• Marie Therese Aymard
• Sahar Ayoubi
• Amir Ayromloo

• Group Psychotherapy Psychologist in San Mateo, CA
• Providers in San Mateo, CA by specialty
• Group Psychotherapy Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.