Individual provider Active NPI

D. Renee Owen, LMFT

  • Marriage & Family Therapist
  • San Rafael, CA
National Provider Identifier
1881058014
Registry record updated Apr 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
35255 Issued in CA
Practice address
1703 5TH Ave Ste 101
San Rafael, CA 94901-1853
Phone
(415) 453-8117
NPI assigned
Apr 13, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 2016

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 35255 CA Primary

Addresses

Primary practice location

1703 5TH Ave Ste 101
San Rafael, CA 94901-1853

Mailing address

1703 5TH Ave Ste 101
San Rafael, CA 94901-1853
Phone (415) 453-8117

Other identifiers 1

IdentifierTypeStateIssuer
35255OtherCALMFT

Other names 1

  • Dawn Renee Owen Former name

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 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
35255CAMDRegistered Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460505600000",
    "number": "1881058014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 5TH AVE STE 101",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011853",
            "telephone_number": "415-453-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 5TH AVE STE 101",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949011853",
            "telephone_number": "415-453-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "D. RENEE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-13",
        "last_updated": "2016-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "35255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "35255",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAWN",
            "last_name": "OWEN",
            "middle_name": "RENEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Rafael, CA

Sources for this page

Verify at the official NPI Registry.