Individual provider Active NPI

Meridel Pearl Tobias, LMFT

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1629269162
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
48745 Issued in CA
Practice address
1850 San Pedro Ave
Berkeley, CA 94707
Phone
(510) 379-4860
Fax
(510) 601-4002
NPI assigned
Aug 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 56385 CA
Marriage & Family Therapist 106H00000X 48745 CA Primary

Addresses

Primary practice location

1850 San Pedro Ave
Berkeley, CA 94707

Mailing address

1791 Solano Av, # F12
Berkeley, CA 94707-2209
Phone (612) 868-9208

Other names 1

  • Ms. Meridel Pearl Nordley-Knox Former name

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

State licenses

LicenseStateTypeSpecialty
48745CAMDMarriage & Family Therapist
56385CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1629269162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 SOLANO AV, # F12",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947072209",
            "telephone_number": "612-868-9208",
            "fax_number": "510-601-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 SAN PEDRO AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "94707",
            "telephone_number": "510-379-4860",
            "fax_number": "510-601-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIAS",
        "first_name": "MERIDEL",
        "middle_name": "PEARL",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-08",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "56385",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "48745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MERIDEL",
            "last_name": "NORDLEY-KNOX",
            "middle_name": "PEARL",
            "prefix": "MS.",
            "credential": "MFTI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 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.

Verify at the official NPI Registry.