Individual provider Active NPI

Jolee Willow Boyd Del Mazo, LMFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1962857722
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
109567 Issued in CA
Practice address
3865 Howe St
Oakland, CA 94611-5343
Phone
(415) 952-6202
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

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 109567 CA Primary

Addresses

Primary practice location

3865 Howe St
Oakland, CA 94611-5343

Mailing address

3906 Delmont Ave
Oakland, CA 94605-2233
Phone (650) 255-9583

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
109567CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1962857722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3906 DELMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052233",
            "telephone_number": "650-255-9583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3865 HOWE ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115343",
            "telephone_number": "415-952-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEL MAZO",
        "first_name": "JOLEE",
        "middle_name": "WILLOW BOYD",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.