MARY SERPHOS (NPI# 1679975478) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679975478 |
| Entity Type | Individual |
| Full Name | MARY SERPHOS |
| Practice Address |
1480 Lincoln Ave San Rafael CA 94901-2084 |
| Practice Telephone | 4154561050 |
| Mailing Telephone | 4154561050 |
| Enumeration Date | 2014-09-23 |
| Last Update Date | 2014-09-23 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
LCS 23301 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1480 LINCOLN AVE |
| City | SAN RAFAEL |
| State | CA |
| Zip Code | 94901-2084 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851463020 | Christine M Vandenbroucke-bouckaert | Psychologist | 1480 Lincoln Ave, #12, San Rafael, CA 94901-2084 | 2006-11-14 |
| 1225533706 | Georgiana Rumman | Marriage & Family Therapist | 1480 Lincoln Ave, San Rafael, CA 94901-2084 | 2018-03-27 |
| 1982149316 | Yoshiko Hedges | Marriage & Family Therapist | 1480 Lincoln Ave, San Rafael, CA 94901-2084 | 2016-12-20 |
| 1467850800 | Christian Frausto | Marriage & Family Therapist | 1480 Lincoln Ave, Suite 8, San Rafael, CA 94901-2084 | 2014-12-17 |
| 1598018558 | Kathleen Leyva | Marriage & Family Therapist | 1480 Lincoln Ave, 8, San Rafael, CA 94901-2084 | 2012-10-16 |
| 1558612689 | Ananya Hixon | Marriage & Family Therapist | 1480 Lincoln Ave, #8, San Rafael, CA 94901-2084 | 2012-09-28 |
| 1528317575 | Meghan K Young | Marriage & Family Therapist | 1480 Lincoln Ave, #8, San Rafael, CA 94901-2084 | 2012-09-06 |
| 1225318801 | Valerie Downing | Marriage & Family Therapist | 1480 Lincoln Ave, San Rafael, CA 94901-2084 | 2011-08-26 |
| 1447539077 | Elizabeth Ann Rea | Marriage & Family Therapist | 1480 Lincoln Ave, #8, San Rafael, CA 94901-2084 | 2011-08-13 |
| 1922326545 | Laurie Javier | Counselor | 1480 Lincoln Ave, Suite 3, San Rafael, CA 94901-2084 | 2010-05-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780207134 | Marianne Haissman Stefancic | Marriage & Family Therapist | 409 Forbes Ave., San Rafael, CA 94901 | 2020-05-20 |
| 1093292765 | Marin Community Clinic | Clinic/Center | 411 4th Strteet, Suite A, San Rafael, CA 94901 | 2018-07-25 |
| 1275052516 | Laura Ellen Silverstein | Marriage & Family Therapist | 600 Fifth Avenue, San Rafael, CA 94901 | 2017-09-19 |
| 1689101107 | Marin Family Recovery | Clinic/Center | 1209 Third St. Ste 4, San Rafael, CA 94901 | 2017-05-15 |
| 1376070011 | Tencia Beavers-sanchez | Counselor | 710 C Street Suite#8, Marin Outpatient&recoveryservices, Sanrafael, CA 94901 | 2017-05-12 |
| 1326584905 | Jamie Waterman | Emergency Medical Technician, Basic | 675 Sir Francis Drake Blvd, Kentfield, CA 94901 | 2017-01-06 |
| 1295270676 | Stephen Marks | Counselor | 900 Fifth Avenue, Suite 150, ; San Rafael, CA 94901 | 2016-12-21 |
| 1497299812 | Vesna Sturman | Psychologist | 712 D St Ste L, San Rafael, CA 94901 | 2016-12-05 |
| 1063955771 | Carol Dutton Hollenberg | Behavior Technician | 503 D St., San Rafael, CA 94901 | 2016-11-29 |
| 1083069447 | Bay Area Community Resources | Community/Behavioral Health | 103 Shoreline Parkway, San Rafael, CA 94901 | 2016-05-04 |
| Find all providers in zip 94901 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851830483 | Bea Ivory-chambers | Counselor | 1330 Lincoln Ave Ste 202b, San Rafael, CA 94901-2142 | 2017-02-15 |
| 1932559069 | Julia Prentice | Counselor | 920 Cresta Way, #6, San Rafael, CA 94903-5573 | 2016-06-20 |
| 1033572771 | Henry Colbert | Counselor | 1 St. St. Vincent Drive, San Rafael, CA 94903 | 2016-03-31 |
| 1033528575 | Diane Louise Ray | Counselor | 4 Majorca Ct, San Rafael, CA 94903-1520 | 2014-08-08 |
| 1487072542 | Julie Lehman | Counselor | 1717 5th Ave Ste E, San Rafael, CA 94901-1810 | 2014-04-04 |
| 1073867081 | Lisa Ann Kubiak | Counselor | 900 Mission Ave, San Rafael, CA 94901-6108 | 2012-10-30 |
| 1740530815 | Deborah Ann Spake | Counselor | 712 D St. Suite P, San Rafael, CA 94901 | 2012-09-14 |
| 1386993210 | Sarah Tischler Aikin | Counselor | 555 Northgate Drive, Suite 100, Family Service Agency of Marin, San Rafael, CA 94903-3680 | 2012-09-06 |
| 1477810182 | Amanda Gloria Jean Conn | Counselor | 980 Lincoln Ave Ste 250, San Rafael, CA 94901-8802 | 2012-04-19 |
| 1558647487 | Katherine O Bregar | Counselor | 361 Third St. Suite G, San Rafael, CA 94901 | 2011-10-24 |
| Find all providers in SAN RAFAEL | ||||
| City | SAN RAFAEL |
| Zip Code | 94901 |
Please comment or provide details below to improve the information on MARY SERPHOS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.