Active NPI
Sara Beth Dornisch, M.ED, AMFT
- Marriage & Family Therapist
- San Francisco, CA
National Provider Identifier
1619638939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 126067
- Practice address
- 201 Sanchez St
San Francisco, CA 94114-1613 - Phone
- (415) 936-0622
- NPI assigned
- Jan 8, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 126067 | CA | Primary |
Addresses
Primary practice location
201 Sanchez St
San Francisco, CA 94114-1613
Mailing address
629 Santa Rosa Ave
Berkeley, CA 94707-1538
Phone (510) 982-9354
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 126067 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641600000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641600000000",
"number": "1619638939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "629 SANTA ROSA AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947071538",
"telephone_number": "510-982-9354"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 SANCHEZ ST",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941141613",
"telephone_number": "415-936-0622"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DORNISCH",
"first_name": "SARA",
"middle_name": "BETH",
"credential": "M.ED, AMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-08",
"last_updated": "2022-01-08",
"certification_date": "2022-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "126067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.