Individual provider Active NPI

Sarah Nicole Tachibana, M.S. , M.F.T.

  • Marriage & Family Therapist
  • San Mateo, CA
National Provider Identifier
1770644247
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52506 Issued in CA
Practice address
39 N San Mateo Dr Ste 5
San Mateo, CA 94401-2832
Phone
(650) 207-7962
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 52506 CA Primary

Addresses

Primary practice location

39 N San Mateo Dr Ste 5
San Mateo, CA 94401-2832

Mailing address

696 San Ramon Valley Blvd # 252
Danville, CA 94526-4022

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
52506CAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1770644247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "696 SAN RAMON VALLEY BLVD # 252",
            "city": "DANVILLE",
            "state": "CA",
            "postal_code": "945264022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N SAN MATEO DR STE 5",
            "city": "SAN MATEO",
            "state": "CA",
            "postal_code": "944012832",
            "telephone_number": "650-207-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACHIBANA",
        "first_name": "SARAH",
        "middle_name": "NICOLE",
        "credential": "M.S. , M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Mateo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.