Individual provider Active NPI

Deborah Ann Spake, LMFT

  • Marriage & Family Therapist
  • Sausalito, CA
National Provider Identifier
1740530815
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109339 Issued in CA
Practice address
100 Phillips Dr
Sausalito, CA 94965-1172
Phone
(415) 339-8813
Fax
(415) 339-8814
NPI assigned
Sep 14, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 109339 CA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

100 Phillips Dr
Sausalito, CA 94965-1172

Mailing address

100 Phillips Dr
Sausalito, CA 94965-1172
Phone (415) 339-8813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251127000139 CA Practitioner - Marriage and Family Therapist 5496247371 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

781 Hart St
Brooklyn, NY 11237-3549

880 Las Gallinas Ave
Suite 7
San Rafael, CA 94903-3463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
109339CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Marin City Health and Wellness Center CurrentSince Sep 15, 2025 Accepting new patients
Marin City Health and Wellness Center CurrentSince Sep 15, 2025 Accepting new patients

Locations

880 Las Gallinas Ave
Ste 2
San Rafael, CA 94903
Phone (415) 339-8813

100 Phillips Dr
Sausalito, CA 94965
Phone (415) 339-8813

630 Drake Ave
Sausalito, CA 94965
Phone (415) 339-8813

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1347580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1740530815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHILLIPS DR",
            "city": "SAUSALITO",
            "state": "CA",
            "postal_code": "949651172",
            "telephone_number": "415-339-8813",
            "fax_number": "415-339-8814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPAKE",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-14",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109339",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sausalito, CA

Sources for this page

Verify at the official NPI Registry.