Individual provider Active NPI

Mandolin Sarah Kladko, LMFT

  • Marriage & Family Therapist
  • Chico, CA
National Provider Identifier
1639443955
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
102090 Issued in CA
Practice address
95 Declaration Dr Ste 5
Chico, CA 95973-4916
Phone
(530) 206-9332
Fax
(530) 433-5270
NPI assigned
Mar 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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 102090 CA Primary

Addresses

Primary practice location

95 Declaration Dr Ste 5
Chico, CA 95973-4916

Mailing address

95 Declaration Dr Ste 5
Chico, CA 95973-4916
Phone (530) 206-9332

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

NPI Registry JSON

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1639443955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 DECLARATION DR STE 5",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734916",
            "telephone_number": "530-206-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 DECLARATION DR STE 5",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959734916",
            "telephone_number": "530-206-9332",
            "fax_number": "530-433-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLADKO",
        "first_name": "MANDOLIN",
        "middle_name": "SARAH",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-05",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "102090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.