Elena Konstantinova Kaloyanova, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT46945 Issued in CA

Practice address

1330 Lincoln Ave Ste 106B
San Rafael, CA 94901-2141

Phone

(510) 388-2130

Fax

(510) 550-1975

NPI assigned

Nov 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

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": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706572800000",
    "number": "1700957875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE STE 106B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012141",
            "telephone_number": "510-388-2130",
            "fax_number": "510-550-1975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 LINCOLN AVE STE 106B",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012141",
            "telephone_number": "510-388-2130",
            "fax_number": "510-550-1975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Saint Vincents Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949031504",
            "country_code": "US",
            "telephone_number": "415-972-1300 x327",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KALOYANOVA",
        "first_name": "ELENA",
        "middle_name": "KONSTANTINOVA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2024-01-30",
        "certification_date": "2024-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF42092",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT46945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Rafael, CA
• Providers in San Rafael, 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 Jan 30, 2024; 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.