Individual provider Active NPI

Mary Katherine Cocharo, LMFT

  • Specialist
  • Santa Monica, CA
National Provider Identifier
1730241456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MFC25394 Issued in CA
Practice address
3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344
Phone
(310) 828-2624
Fax
(319) 829-4838
NPI assigned
Dec 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MFC25394 CA Primary

Addresses

Primary practice location

3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344

Mailing address

3201 Wilshire Blvd
Suite 209
Santa Monica, CA 90403-2344
Phone (310) 828-2624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 25, 2024 through Apr 25, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
25394CAMDClinical Psychologist
MFC25394CAMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1166227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730241456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD",
            "address_2": "SUITE 209",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032344",
            "telephone_number": "310-828-2624",
            "fax_number": "319-829-4838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3201 WILSHIRE BLVD",
            "address_2": "SUITE 209",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904032344",
            "telephone_number": "310-828-2624",
            "fax_number": "319-829-4838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COCHARO",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "MFC25394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.