Mae Pearl Ta, AMFT, APCC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

122719 Issued in CA

Practice address

1835 Park Ave
San Jose, CA 95126-1629

Phone

(303) 989-8169

NPI assigned

Jun 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1623801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1831767888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 SUNOL ST UNIT 336",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951264380",
            "telephone_number": "669-226-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 PARK AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951261629",
            "telephone_number": "303-989-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TA",
        "first_name": "MAE",
        "middle_name": "PEARL",
        "credential": "AMFT, APCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-16",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "8808",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "122719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aborn Vu Ta, MFT TRAINEE
• Diana U Ta
• Elisa Ta, PHARM.D.
• Hong Doan Ta
• Lien Chau Ta
• Thanh D. Ta, PHARM.D.
• Theresa Ta, DDS
• Vuong Ta
• Vitani F Taamu
• Blanca Isela Tabares, LCSW

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2023; 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.