Active NPI
Colette R. Fujimoto, MFT
- Marriage & Family Therapist
- Larkspur, CA
National Provider Identifier
1982803706
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 61961
- Practice address
- 5 Bon Air Rd
Suite 220
Larkspur, CA 94939-1143 - Phone
- (415) 924-2569
- NPI assigned
- Jul 12, 2007
- Sex
- Female
- 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 | 61961 | CA | Primary |
Addresses
Primary practice location
5 Bon Air Rd
Suite 220
Larkspur, CA 94939-1143
Mailing address
5 Bon Air Rd
Suite 220
Larkspur, CA 94939-1143
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 |
|---|---|---|---|
| 61961 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1360627200000",
"number": "1982803706",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 BON AIR RD",
"address_2": "SUITE 220",
"city": "LARKSPUR",
"state": "CA",
"postal_code": "949391143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 BON AIR RD",
"address_2": "SUITE 220",
"city": "LARKSPUR",
"state": "CA",
"postal_code": "949391143",
"telephone_number": "415-924-2569"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUJIMOTO",
"first_name": "COLETTE",
"middle_name": "R.",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-12",
"last_updated": "2013-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "61961",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Larkspur, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 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.