Individual provider Active NPI

Agnes Edith Matter-Dang

  • Counselor
  • San Jose, CA
National Provider Identifier
1932488657
Registry record updated Aug 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
1245 E Santa Clara St
Alum Rock Counseling Center
San Jose, CA 95116-2337
Phone
(408) 294-0500
NPI assigned
Aug 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

1245 E Santa Clara St
Alum Rock Counseling Center
San Jose, CA 95116-2337

Mailing address

1310 Saddle Rack St
# 402
San Jose, CA 95126-3498
Phone (650) 799-2585

Other names 1

  • Agnes Edith Dang Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1313020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313020800000",
    "number": "1932488657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 SADDLE RACK ST",
            "address_2": "# 402",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951263498",
            "telephone_number": "650-799-2585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1245 E SANTA CLARA ST",
            "address_2": "ALUM ROCK COUNSELING CENTER",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162337",
            "telephone_number": "408-294-0500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTER-DANG",
        "first_name": "AGNES",
        "middle_name": "EDITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-11",
        "last_updated": "2011-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AGNES",
            "last_name": "DANG",
            "middle_name": "EDITH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2011; 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.