Katherine Alexandra Mancera

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT122960 Issued in CA

Practice address

171 Carlos Dr
San Rafael, CA 94903-2005

Phone

(646) 346-9568

NPI assigned

May 20, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

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": "1589932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604880000000",
    "number": "1760005060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1726 19TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946064632",
            "telephone_number": "646-346-9568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 CARLOS DR",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949032005",
            "telephone_number": "646-346-9568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCERA",
        "first_name": "KATHERINE",
        "middle_name": "ALEXANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-20",
        "last_updated": "2020-11-09",
        "certification_date": "2020-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT122960",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria Maldonado, RDA
• Walter T. Mallory, M.A.
• Ryan Nicole Malone, SUDRC
• Daniel James Maloney, M.D.
• Ilene Malt
• Nancy Mancias
• Deepti Manepalli
• Ashley Manisap
• Jasmine Maniti, PMHNP-BC
• Angela Catalina Manjarrez, LVN

• 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 Nov 9, 2020; 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.