Active NPI
Kirsten Haney
- Marriage & Family Therapist
- San Leandro, CA
National Provider Identifier
1942621404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- INTERN 72080
- Practice address
- 545 Estudillo Ave
San Leandro, CA 94577-4611 - Phone
- (510) 352-9200
- NPI assigned
- Dec 30, 2013
- 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 | INTERN 72080 | CA | Primary |
Addresses
Primary practice location
545 Estudillo Ave
San Leandro, CA 94577-4611
Mailing address
4709 Michelle Way
Union City, CA 94587-5038
Phone (510) 304-5391
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 |
|---|---|---|---|
| INTERN 72080 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1388361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1388361600000",
"number": "1942621404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4709 MICHELLE WAY",
"city": "UNION CITY",
"state": "CA",
"postal_code": "945875038",
"telephone_number": "510-304-5391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 ESTUDILLO AVE",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945774611",
"telephone_number": "510-352-9200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANEY",
"first_name": "KIRSTEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-12-30",
"last_updated": "2013-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "INTERN 72080",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Leandro, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.