Active NPI
Doreen Roheil Maller, MFTI
- Marriage & Family Therapist
- San Mateo, CA
National Provider Identifier
1821212093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 46655
- Practice address
- 1670 S Amphlett Blvd
#115
San Mateo, CA 94402 - Phone
- (650) 294-2621
- Fax
- (650) 349-1103
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 46655 | CA | Primary |
Addresses
Primary practice location
1670 S Amphlett Blvd
#115
San Mateo, CA 94402
Mailing address
PO Box 1312
Burlingame, CA 94011
Phone (650) 576-3565
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: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 2, 2024 through Jan 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 45737 | CA | MD | General Practice Dentistry |
| 46655 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821212093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1312",
"city": "BURLINGAME",
"state": "CA",
"postal_code": "94011",
"telephone_number": "650-576-3565",
"fax_number": "650-342-8281"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1670 S AMPHLETT BLVD",
"address_2": "#115",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "94402",
"telephone_number": "650-294-2621",
"fax_number": "650-349-1103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLER",
"first_name": "DOREEN",
"middle_name": "ROHEIL",
"name_prefix": "Mrs.",
"credential": "MFTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "46655",
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.