Individual provider Active NPI

Tierney Cathleen Estampa

  • Marriage & Family Therapist
  • El Sobrante, CA
National Provider Identifier
1740622653
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
100535 Issued in CA
Practice address
4892 San Pablo Dam Rd
El Sobrante, CA 94803-3222
Phone
(510) 222-3946
NPI assigned
Jul 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Student in an Organized Health Care Education/Training Program 390200000X IMF100535 CA
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 100535 CA Primary

Addresses

Primary practice location

4892 San Pablo Dam Rd
El Sobrante, CA 94803-3222

Mailing address

4892 San Pablo Dam Rd
El Sobrante, CA 94803-3222

Other practice location 1

2853 Groom Dr
Richmond, CA 94806-2664
Phone (510) 222-3946

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
100535CAMDDentist
IMF100535CAMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1740622653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4892 SAN PABLO DAM RD",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948033222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4892 SAN PABLO DAM RD",
            "city": "EL SOBRANTE",
            "state": "CA",
            "postal_code": "948033222",
            "telephone_number": "510-222-3946"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2853 Groom Dr",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "CA",
            "postal_code": "948062664",
            "country_code": "US",
            "telephone_number": "510-222-3946",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ESTAMPA",
        "first_name": "TIERNEY",
        "middle_name": "CATHLEEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "IMF100535",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "100535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Sobrante, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2019; 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.