Individual provider Active NPI

Adrianna Kristine Agans

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1851831242
Registry record updated Jul 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT107761 Issued in CA
Practice address
2495 W March LN
Stockton, CA 95207
Phone
(209) 465-1080
NPI assigned
Mar 3, 2017
Last updated
Jul 13, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2022

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 NU
Marriage & Family Therapist 106H00000X AMFT107761 CA Primary

Addresses

Primary practice location

2495 W March LN
Stockton, CA 95207

Mailing address

1414 N California St
Stockton, CA 95202-1515
Phone (209) 468-2395

Other practice location 1

1414 N California St
Stockton, CA 95202-1515
Phone (209) 468-2395

Other practice location 2

609 Price Ave Ste 205
Redwood City, CA 94063-1403
Phone (650) 366-8436

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT107761CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Behavioral Health Services Mental Health Current Accepting new patients

Locations

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1488499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1851831242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 N CALIFORNIA ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952021515",
            "telephone_number": "209-468-2395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2495 W MARCH LN",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95207",
            "telephone_number": "209-465-1080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1414 N California St",
            "address_purpose": "LOCATION",
            "city": "Stockton",
            "state": "CA",
            "postal_code": "952021515",
            "country_code": "US",
            "telephone_number": "209-468-2395",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "609 Price Ave Ste 205",
            "address_purpose": "LOCATION",
            "city": "Redwood City",
            "state": "CA",
            "postal_code": "940631403",
            "country_code": "US",
            "telephone_number": "650-366-8436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGANS",
        "first_name": "ADRIANNA",
        "middle_name": "KRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-03",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT107761",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.