Mina Alexandra Skoutelakis, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 40793 Issued in CA

Practice address

699 Peters Ave Ste a
Pleasanton, CA 94566-6579

Phone

(925) 216-6561

NPI assigned

Dec 18, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 21, 2024 through Nov 21, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stoneridge Counseling Services

  • Mental Health Counselor
  • Pleasanton, CA
  • NPI 1932716008
  NPD (past)

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1902969405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "699 PETERS AVE STE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666579",
            "telephone_number": "925-216-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "699 PETERS AVE STE A",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945666579",
            "telephone_number": "925-216-6561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SKOUTELAKIS",
        "first_name": "MINA",
        "middle_name": "ALEXANDRA",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 40793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Alan Sire, C.P.O
• Chloe Sissa
• Craig C. Sjoberg, D.D.S.
• Nicole Skeele, LCSW
• Skin Time RX PC (Skin Time Rx)
• Ciara Lillian Skye
• Jeanie Slater
• Rebecca S. Slaughter
• Alexia A Smith
• Alicia Smith, FNP

• Marriage & Family Therapist in Pleasanton, CA
• Providers in Pleasanton, 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 Dec 13, 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.

Verify at the official NPI Registry.