Active NPI
Cynthia Grogan Gallagher
- Marriage & Family Therapist
- San Carlos, CA
National Provider Identifier
1538766811
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 1139 San Carlos Ave Ste 308
San Carlos, CA 94070-2450 - Phone
- (650) 868-7251
- NPI assigned
- Oct 8, 2020
- Last updated
- Oct 8, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 111045 | CA | |
| Marriage & Family Therapist | 106H00000X | NU | Primary |
Addresses
Primary practice location
1139 San Carlos Ave Ste 308
San Carlos, CA 94070-2450
Mailing address
1139 San Carlos Ave Ste 308
San Carlos, CA 94070-2450
Phone (650) 868-7251
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111045 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1602115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1602115200000",
"number": "1538766811",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1139 SAN CARLOS AVE STE 308",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702450",
"telephone_number": "650-868-7251"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 SAN CARLOS AVE STE 308",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702450",
"telephone_number": "650-868-7251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALLAGHER",
"first_name": "CYNTHIA",
"middle_name": "GROGAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-10-08",
"last_updated": "2020-10-08",
"certification_date": "2020-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "111045",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.