Individual provider Active NPI

Christina De Cossio, MFT

  • Marriage & Family Therapist
  • Grass Valley, CA
National Provider Identifier
1962129015
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125430 Issued in CA
Practice address
12735 Allison Ranch Rd
Grass Valley, CA 95949-9606
Phone
(415) 606-0040
NPI assigned
Oct 20, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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 125430 CA Primary

Addresses

Primary practice location

12735 Allison Ranch Rd
Grass Valley, CA 95949-9606

Mailing address

12735 Allison Ranch Rd
Grass Valley, CA 95949-9606
Phone (415) 606-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260618003723 CA Practitioner - Marriage and Family Therapist 6800368937 Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1924 4TH St
Suite C
San Rafael, CA 94901-2698
Phone (415) 606-0040

448 Colfax Ave
Grass Valley, CA 95945-6840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1666224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1962129015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12735 ALLISON RANCH RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959499606",
            "telephone_number": "415-606-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12735 ALLISON RANCH RD",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959499606",
            "telephone_number": "415-606-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE COSSIO",
        "first_name": "CHRISTINA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-20",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grass Valley, CA

Sources for this page

Verify at the official NPI Registry.