Active NPI
Mary Ann Kacerguis, MFT
- Marriage & Family Therapist
- Antioch, CA
National Provider Identifier
1619028990
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 29097
- Practice address
- 2225 Buchanan Rd
Antioch, CA 94509-4209 - Phone
- (925) 681-8098
- NPI assigned
- Jan 15, 2007
- Last updated
- Apr 11, 2018
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 29097 | CA | Primary |
Addresses
Primary practice location
2225 Buchanan Rd
Antioch, CA 94509-4209
Mailing address
4833 Boxer Blvd
Concord, CA 94521-3602
Phone (925) 685-5478
Other practice location 1
2579 San Pablo Ave
Oakland, CA 94612-1159
Phone (510) 466-7161
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 8, 2024 through Jan 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 29097 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168819200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1523404800000",
"number": "1619028990",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4833 BOXER BLVD",
"city": "CONCORD",
"state": "CA",
"postal_code": "945213602",
"telephone_number": "925-685-5478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 BUCHANAN RD",
"city": "ANTIOCH",
"state": "CA",
"postal_code": "945094209",
"telephone_number": "925-681-8098"
}
],
"practiceLocations": [
{
"address_1": "2579 San Pablo Ave",
"address_purpose": "LOCATION",
"city": "Oakland",
"state": "CA",
"postal_code": "946121159",
"country_code": "US",
"telephone_number": "510-466-7161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KACERGUIS",
"first_name": "MARY ANN",
"name_prefix": "Dr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-15",
"last_updated": "2018-04-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 29097",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Antioch, CA
- Juneva Health, LLC
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- Jodi Sue Kabat, M.P.T.
- Samuel J Kabat, MPT
- Kaiser Foundation Health Plan Inc (Kaiser Permanente Pharmacy #571)
- Kaiser Foundation Health Plan Inc (Kaiser Health Plan Main Phy 551)
- Kaiser Foundation Health Plan Inc (Kaiser Permanente Pharmacy #572)
- Kaiser Foundation Health Plan Inc (Kaiser Oncology Pharmacy #573)
- Kaiser Foundation Hospitals (Kaiser Found Hospital Phrmcy #57a)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2018; 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.