Individual provider Active NPI

Stefanie Jean Bond, AMFT

  • Student in an Organized Health Care Education/Training Program
  • San Rafael, CA
National Provider Identifier
1831621879
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1601 2ND St
San Rafael, CA 94901-2712
Phone
(415) 454-9444
Fax
(415) 454-4864
NPI assigned
Mar 29, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 110271 CA
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1601 2ND St
San Rafael, CA 94901-2712

Mailing address

2 Cresta Cir Apt 1
San Rafael, CA 94903-1906
Phone (415) 755-0130

Other practice location 1

2501 Harrison St
Oakland, CA 94612-3811
Phone (510) 444-3344

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
110271CAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
John F. Kennedy University Mental Health Past Accepting new patients
Oakland Counseling Center PastSince Nov 24, 2019 Accepting new patients
Center Point, Inc. Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1831621879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 CRESTA CIR APT 1",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031906",
            "telephone_number": "415-755-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 2ND ST",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949012712",
            "telephone_number": "415-454-9444",
            "fax_number": "415-454-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 Harrison St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946123811",
            "country_code": "US",
            "telephone_number": "510-444-3344",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOND",
        "first_name": "STEFANIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-29",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "110271",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Rafael, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2019; 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.