Individual provider Active NPI

Kate E Brennan, MFT

  • Marriage & Family Therapist
  • San Anselmo, CA
National Provider Identifier
1922242437
Registry record updated May 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT31122 Issued in CA
Practice address
558 San Anselmo Ave
San Anselmo, CA 94960-2621
Phone
(415) 453-1402
NPI assigned
Apr 28, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2011

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 MFT31122 CA Primary

Addresses

Primary practice location

558 San Anselmo Ave
San Anselmo, CA 94960-2621

Mailing address

173 Ridge Rd
San Anselmo, CA 94960-1473
Phone (415) 453-1402

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
31122CAMDClinical Psychologist
MFT31122CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306454400000",
    "number": "1922242437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 RIDGE RD",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949601473",
            "telephone_number": "415-453-1402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 SAN ANSELMO AVE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "949602621",
            "telephone_number": "415-453-1402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "KATE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2011-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT31122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Anselmo, CA

Sources for this page

Verify at the official NPI Registry.