Active NPI
Angela Congdon, LMFT
- Mental Health Counselor
- San Jose, CA
National Provider Identifier
1871946251
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 49930
- Practice address
- 1190 S Bascom Ave
Suite 130
San Jose, CA 95128-3545 - Phone
- (408) 234-1405
- NPI assigned
- Jul 20, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 49930 | CA | Primary |
Addresses
Primary practice location
1190 S Bascom Ave
Suite 130
San Jose, CA 95128-3545
Mailing address
1190 S Bascom Ave
Suite 130
San Jose, CA 95128-3545
Phone (408) 234-1405
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 30, 2024 through Jan 30, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49930 | CA | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468972800000",
"number": "1871946251",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1190 S BASCOM AVE",
"address_2": "SUITE 130",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283545",
"telephone_number": "408-234-1405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 S BASCOM AVE",
"address_2": "SUITE 130",
"city": "SAN JOSE",
"state": "CA",
"postal_code": "951283545",
"telephone_number": "408-234-1405"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONGDON",
"first_name": "ANGELA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-20",
"last_updated": "2016-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "49930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Jose, CA
- Katelhyn Nhyckarose Tolentino Concio
- Concordis Behavioral Health, a Professional Nursing Organization
- John Douglas Condie Jr., M.D.
- Raia Grace Coney
- Confidence Home Health, LLC
- Erica Conger, MSW, ASW
- Miles Robert Congress, M.D
- Amanda Marie Conklin
- Mercedes Almela Conklin, MD
- Kristine E Conley, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.