Active NPI
Elise Von Tersch
- Marriage & Family Therapist
- Brentwood, CA
National Provider Identifier
1922303783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 110339
- Practice address
- 218 Delta Ave
Brentwood, CA 94513-1603 - Phone
- (925) 513-5611
- NPI assigned
- Jan 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 110339 | CA | Primary |
Addresses
Primary practice location
218 Delta Ave
Brentwood, CA 94513-1603
Mailing address
875 Crescent Dr
Brentwood, CA 94513-2907
Phone (916) 730-3820
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
| License | State | Type | Specialty |
|---|---|---|---|
| 110339 | CA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549411200000",
"number": "1922303783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "875 CRESCENT DR",
"city": "BRENTWOOD",
"state": "CA",
"postal_code": "945132907",
"telephone_number": "916-730-3820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "218 DELTA AVE",
"city": "BRENTWOOD",
"state": "CA",
"postal_code": "945131603",
"telephone_number": "925-513-5611"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VON TERSCH",
"first_name": "ELISE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-25",
"last_updated": "2019-02-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "110339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brentwood, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.