Jill Mattesich-Udoutch

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

90 Mission Dr Ste 5
Pleasanton, CA 94566-7655

Phone

(925) 960-3552

NPI assigned

Jan 22, 2020

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 Dec 19, 2024 through Dec 19, 2026

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mind & Spirit Counseling Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Pleasanton, CA
  • NPI 1750921623
  NPD Authorized official

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1912537648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1138 FLORENCE RD",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945505545",
            "telephone_number": "925-960-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 MISSION DR STE 5",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945667655",
            "telephone_number": "925-960-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTESICH-UDOUTCH",
        "first_name": "JILL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nobumasa Masubuchi
• Priscilla Mathews
• Nozomi Matsunami
• Karol Matsune, PHARM.D.
• Clara Matta
• Erika Mattison
• Olivia McAfee
• Alexis Andrea McBride
• Robert McCabe, MD
• Barbara McCarrick, OTR/L

• 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 Jan 22, 2020; 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.