Individual provider Active NPI

Elizabeth Concordia Basile, M.A.

  • Marriage & Family Therapist
  • Mountain View, CA
National Provider Identifier
1790061497
Registry record updated Oct 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC48300 Issued in CA
Practice address
201 San Antonio Cir
Suite C-125
Mountain View, CA 94040-1254
Phone
(408) 718-6915
NPI assigned
Oct 25, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2011

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 MFC48300 CA Primary

Addresses

Primary practice location

201 San Antonio Cir
Suite C-125
Mountain View, CA 94040-1254

Mailing address

201 San Antonio Cir
Suite C-125
Mountain View, CA 94040-1254
Phone (408) 718-6915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC48300CAMDMarriage & Family Therapist
48300CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319500800000",
    "number": "1790061497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 SAN ANTONIO CIR",
            "address_2": "SUITE C-125",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401254",
            "telephone_number": "408-718-6915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SAN ANTONIO CIR",
            "address_2": "SUITE C-125",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940401254",
            "telephone_number": "408-718-6915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASILE",
        "first_name": "ELIZABETH",
        "middle_name": "CONCORDIA",
        "credential": "M.A.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-25",
        "last_updated": "2011-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC48300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain View, CA

Sources for this page

Verify at the official NPI Registry.