Individual provider Active NPI

Elina Rudoy, MFTI

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1750432290
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
112870 Issued in CA
Practice address
150 Executive Park Blvd
Suite 4000
San Francisco, CA 94134-3303
Phone
(415) 871-8805
NPI assigned
Jan 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 112870 CA Primary

Addresses

Primary practice location

150 Executive Park Blvd
Suite 4000
San Francisco, CA 94134-3303

Mailing address

150 Executive Park Blvd
Suite 4000
San Francisco, CA 94134-3303
Phone (415) 871-8805

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
I20260227003548 CA Practitioner - Marriage and Family Therapist 0042791931 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2006
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12301 Wilshire Blvd
Suite 512
Los Angeles, CA 90025-1053

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112870CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mellow Medical Inc a Professional Corporation CurrentSince Feb 16, 2026 Accepting new patients
Hlca, Inc. PastSince Sep 8, 2019 Accepting new patients

Locations

12301 Wilshire Blvd
Ste 512
Los Angeles, CA 90025
Phone (833) 427-3566

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

8235 Santa Monica Blvd
Ste 302
West Hollywood, CA 90046
Phone (310) 892-4284

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9357/brand/1/csg/1/fhir/r4

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1750432290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 4000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941343303",
            "telephone_number": "415-871-8805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 EXECUTIVE PARK BLVD",
            "address_2": "SUITE 4000",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941343303",
            "telephone_number": "415-871-8805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDOY",
        "first_name": "ELINA",
        "credential": "MFTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-12",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "112870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.