Active NPI
Ivan Skolnikoff, M.A.
- Marriage & Family Therapist
- Berkeley, CA
National Provider Identifier
1942219126
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC35832
- Practice address
- 2127 Ashby Ave
Berkeley, CA 94705-1884 - Phone
- (510) 496-6029
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | MFC35832 | CA | Primary |
Addresses
Primary practice location
2127 Ashby Ave
Berkeley, CA 94705-1884
Mailing address
44 Wildwood PL
El Cerrito, CA 94530-2049
Phone (510) 502-7554
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 28, 2024 through Dec 28, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC35832 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1680566400000",
"number": "1942219126",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 WILDWOOD PL",
"city": "EL CERRITO",
"state": "CA",
"postal_code": "945302049",
"telephone_number": "510-502-7554"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2127 ASHBY AVE",
"city": "BERKELEY",
"state": "CA",
"postal_code": "947051884",
"telephone_number": "510-496-6029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKOLNIKOFF",
"first_name": "IVAN",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2023-04-04",
"certification_date": "2023-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC35832",
"primary": true
}
],
"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 Apr 4, 2023; 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.