Individual provider Active NPI

Phyllis C Rothblatt, MFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1649560988
Registry record updated Mar 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC30233 Issued in CA
Practice address
3301 E 12TH St
Suite 259
Oakland, CA 94601-3424
Phone
(510) 325-3077
NPI assigned
Apr 7, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2015

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 MFC30233 CA Primary

Addresses

Primary practice location

3301 E 12TH St
Suite 259
Oakland, CA 94601-3424

Mailing address

4287 Piedmont Ave
Suite 111
Oakland, CA 94611-4730
Phone (510) 325-3077

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 10, 2024 through Sep 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC30233CAMDMarriage & Family Therapist
30233CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1302134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1649560988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4287 PIEDMONT AVE",
            "address_2": "SUITE 111",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114730",
            "telephone_number": "510-325-3077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3301 E 12TH ST",
            "address_2": "SUITE 259",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946013424",
            "telephone_number": "510-325-3077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROTHBLATT",
        "first_name": "PHYLLIS",
        "middle_name": "C",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-07",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC30233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.