Individual provider Active NPI

Aneesa Elizabeth Vaez-Iravani, LMFT

  • Marriage & Family Therapist
  • San Jose, CA
National Provider Identifier
1861165342
Registry record updated Jul 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
154297 Issued in CA
Practice address
1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone
(925) 282-1778
Fax
(415) 296-5299
NPI assigned
Jul 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 154297 CA Primary

Addresses

Primary practice location

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908

Mailing address

1245 S Winchester Blvd Ste 110
San Jose, CA 95128-3908
Phone (925) 282-1778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250808003216 CA Practitioner - Marriage and Family Therapist 7618475617 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
154297CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Coast Psychiatric Associates Inc CurrentSince Aug 23, 2025 Accepting new patients
Gardner Family Health Network, Inc. PastSince Aug 17, 2025 Accepting new patients

Locations

1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292

490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944

1245 S Winchester Blvd
Ste 110
San Jose, CA 95128
Phone (415) 296-5299

Organizations & group practices 2

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753142400000",
    "number": "1861165342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 S WINCHESTER BLVD STE 110",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951283908",
            "telephone_number": "925-282-1778",
            "fax_number": "415-296-5299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAEZ-IRAVANI",
        "first_name": "ANEESA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-29",
        "last_updated": "2025-07-22",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "154297",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

Verify at the official NPI Registry.