Individual provider Active NPI

Jane Cunningham

  • Mental Health Counselor
  • Kentfield, CA
National Provider Identifier
1821265067
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MFT23754 Issued in CA
Practice address
1036 Sir Francis Drake Blvd
Kentfield, CA 94904-1427
Phone
(415) 459-8048
NPI assigned
May 15, 2008
Last updated
May 15, 2008By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MFT23754 CA Primary

Addresses

Primary practice location

1036 Sir Francis Drake Blvd
Kentfield, CA 94904-1427

Mailing address

1036 Sir Francis Drake Blvd
Kentfield, CA 94904-1427
Phone (415) 459-8048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT23754CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1210809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1821265067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1036 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041427",
            "telephone_number": "415-459-8048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SIR FRANCIS DRAKE BLVD",
            "city": "KENTFIELD",
            "state": "CA",
            "postal_code": "949041427",
            "telephone_number": "415-459-8048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "JANE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-15",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT23754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kentfield, CA

Sources for this page

Verify at the official NPI Registry.