Individual provider Active NPI

Andy Herman Mattern, MFT

  • Marriage & Family Therapist
  • Redwood Valley, CA
National Provider Identifier
1982750246
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC29144 Issued in CA
Practice address
2380 Road E
Redwood Valley, CA 95470-9517
Phone
(707) 485-1183
Fax
(707) 485-1310
NPI assigned
Jan 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC29144 CA Primary

Addresses

Primary practice location

2380 Road E
Redwood Valley, CA 95470-9517

Mailing address

2380 Road E
Redwood Valley, CA 95470-9517
Phone (707) 485-1183

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

LicenseStateTypeSpecialty
MFC29144CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982750246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 ROAD E",
            "city": "REDWOOD VALLEY",
            "state": "CA",
            "postal_code": "954709517",
            "telephone_number": "707-485-1183",
            "fax_number": "707-485-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2380 ROAD E",
            "city": "REDWOOD VALLEY",
            "state": "CA",
            "postal_code": "954709517",
            "telephone_number": "707-485-1183",
            "fax_number": "707-485-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERN",
        "first_name": "ANDY",
        "middle_name": "HERMAN",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC29144",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redwood Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.