Individual provider Active NPI

Joelle L. Crepsac, LMFT, ATR, APCC

  • Marriage & Family Therapist
  • San Leandro, CA
National Provider Identifier
1801081385
Registry record updated Jun 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138513 Issued in CA
Practice address
16378 E 14TH St Ste 101
San Leandro, CA 94578-5121
Phone
(510) 459-8046
NPI assigned
Sep 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2024

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 138513 CA Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Professional Counselor 101YP2500X 10142 CA
Art Therapist 221700000X 24-189 CA
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

16378 E 14TH St Ste 101
San Leandro, CA 94578-5121

Mailing address

3044 75TH Ave
Oakland, CA 94605-2906
Phone (650) 520-5833

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
138513CAMDMarriage & Family Therapist
24-189CAMDArt Therapist

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1801081385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3044 75TH AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052906",
            "telephone_number": "650-520-5833",
            "fax_number": "510-777-1187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16378 E 14TH ST STE 101",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945785121",
            "telephone_number": "510-459-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CREPSAC",
        "first_name": "JOELLE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LMFT, ATR, APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-07",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138513",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "10142",
            "primary": false
        },
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "CA",
            "license": "24-189",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "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 Jun 25, 2024; 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.