Individual provider Active NPI

Mary Stefanie Smith, LMFT

  • Marriage & Family Therapist
  • Saratoga, CA
National Provider Identifier
1578040341
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
107296 Issued in CA
Practice address
18855 Aspesi Dr
Saratoga, CA 95070-5209
Phone
(408) 426-0958
NPI assigned
Jul 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 107296 CA Primary

Addresses

Primary practice location

18855 Aspesi Dr
Saratoga, CA 95070-5209

Mailing address

15466 Los Gatos Blvd Ste 109-151
Los Gatos, CA 95032-2542
Phone (408) 426-0958

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Feb 9, 2024 through Feb 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
107296CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1532476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1578040341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15466 LOS GATOS BLVD STE 109-151",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950322542",
            "telephone_number": "408-426-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18855 ASPESI DR",
            "city": "SARATOGA",
            "state": "CA",
            "postal_code": "950705209",
            "telephone_number": "408-426-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MARY",
        "middle_name": "STEFANIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-25",
        "last_updated": "2021-11-03",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "107296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saratoga, CA

Sources for this page

Verify at the official NPI Registry.