John Andersen, LMFT
Individual provider Active NPI Marriage & Family Therapist · El Dorado Hills, CA
NPI 1508323866 · NPPES record last updated Jan 8, 2025
Key facts
- NPI
- 1508323866
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 107436 (CA)
- Practice address
- 5000 Windplay Dr Ste 1
El Dorado Hills, CA 95762-9319 - Phone
- (916) 583-8505
- NPI assigned
- Feb 22, 2019
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 30, 2026 through Mar 30, 2028
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 107436 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Services Associates a Professional Psychological Corporat | Marriage & Family Therapist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 107436 | CA | Yes |
Addresses
Primary practice location
5000 Windplay Dr Ste 1
El Dorado Hills, CA 95762-9319
Mailing address
2222 Francisco Dr Ste 220-268
El Dorado Hills, CA 95762-3762
Phone (916) 583-8505
Other providers in El Dorado Hills, CA
- Ambrose Chiropractic Inc.
- Ambrose Injury and Wellness, a Nursing Corp
- Joseph R. Ambrose
- American River Counseling LLC
- American River Marriage and Family Counseling
- Diamond Anderson
- Donelle Anderson
- Maxine Angel
- Angelo Chiropractic, Inc
- Timothy Pheasant Angelo
All providers in El Dorado Hills, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.