Individual provider Active NPI

Tara R Saunders

  • Marriage & Family Therapist
  • Berkeley, CA
National Provider Identifier
1912644899
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
136222 Issued in CA
Practice address
2709 Alcatraz Ave
Berkeley, CA 94705-2705
Phone
(510) 842-7097
NPI assigned
May 12, 2022
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 136222 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

2709 Alcatraz Ave
Berkeley, CA 94705-2705

Mailing address

2709 Alcatraz Ave
Berkeley, CA 94705-2705
Phone (510) 842-7097

Other practice location 1

2208 San Leandro Blvd
San Leandro, CA 94577-5957
Phone (510) 483-6715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
136222CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lindsey Antin Individual and Family Counseling Inc. CurrentSince Sep 5, 2023 Accepting new patients

Locations

2709 Alcatraz Ave
Berkeley, CA 94705
Phone (510) 299-1759

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1912644899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 ALCATRAZ AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052705",
            "telephone_number": "510-842-7097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 ALCATRAZ AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052705",
            "telephone_number": "510-842-7097"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2208 San Leandro Blvd",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "945775957",
            "country_code": "US",
            "telephone_number": "510-483-6715",
            "fax_number": "510-483-6719",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAUNDERS",
        "first_name": "TARA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "136222",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.