Individual provider Active NPI

Mina Millen, LMFT

  • Mental Health Counselor
  • San Jose, CA
National Provider Identifier
1558016725
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
131169 Issued in CA
Practice address
3880 S Bascom Ave Ste 202
San Jose, CA 95124-2675
Phone
(408) 559-1115
NPI assigned
Feb 16, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 131169 CA Primary

Addresses

Primary practice location

3880 S Bascom Ave Ste 202
San Jose, CA 95124-2675

Mailing address

119 Calle Marguerita
Los Gatos, CA 95032-1245
Phone (408) 891-3964

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

LicenseStateTypeSpecialty
131169CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1644969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1558016725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 CALLE MARGUERITA",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950321245",
            "telephone_number": "408-891-3964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3880 S BASCOM AVE STE 202",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951242675",
            "telephone_number": "408-559-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLEN",
        "first_name": "MINA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-16",
        "last_updated": "2022-02-16",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "131169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.