Individual provider Active NPI

Nicolas Kent Knudsen, MFT

  • School Counselor
  • San Leandro, CA
National Provider Identifier
1790988137
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
School CounselorTaxonomy code 101YS0200X
License
2301033783 Issued in CA
Practice address
2200 Bancroft Ave
San Leandro, CA 94577-6108
Phone
(510) 618-4600
NPI assigned
Jun 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
School Counselor 101YS0200X 2301033783 CA Primary
Marriage & Family Therapist 106H00000X MFC53922 CA

Addresses

Primary practice location

2200 Bancroft Ave
San Leandro, CA 94577-6108

Mailing address

PO Box 613
San Lorenzo, CA 94580-0613
Phone (415) 377-5827

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
2301033783CAMDSchool Counselor
MFC53922CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1790988137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 613",
            "city": "SAN LORENZO",
            "state": "CA",
            "postal_code": "945800613",
            "telephone_number": "415-377-5827",
            "fax_number": "415-377-5827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 BANCROFT AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945776108",
            "telephone_number": "510-618-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSEN",
        "first_name": "NICOLAS",
        "middle_name": "KENT",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-05",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "CA",
            "license": "2301033783",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC53922",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2026; 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.