Soudabeh Azizi

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC42631 Issued in CA

Practice address

661 Live Oak Ave Ste 5
Menlo Park, CA 94025-4863

Phone

(650) 857-1477

Fax

(650) 857-1477

NPI assigned

Feb 10, 2015

Last updated

Feb 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1423526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1700277902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 LIVE OAK AVE STE 5",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254863",
            "telephone_number": "650-857-1477",
            "fax_number": "650-857-1477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 LIVE OAK AVE STE 5",
            "city": "MENLO PARK",
            "state": "CA",
            "postal_code": "940254863",
            "telephone_number": "650-857-1477",
            "fax_number": "650-857-1477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AZIZI",
        "first_name": "SOUDABEH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-10",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC42631",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Auf Der Springe, PT, DPT
• Avellino Lab USA, Inc.
• Timothy J Avery, PSY.D.
• Paige Avitabile
• Rubi Nunez Ayala, ASW , MSW
• Baart Behavioral Health Services, Inc. (BAART Programs San Mateo)
• Baart Programs San Mateo
• Adrienne Bachleda
• Ellyn Bader, MFT, PH.D
• Bal Bagwat, MD

• Marriage & Family Therapist in Menlo Park, CA
• Providers in Menlo Park, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2015; 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.