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HADI KOESNODIHARDJO
NPI 1073735700
Marriage & Family Therapist in Redwood City, CA

Active since May 03, 2007PECOS EnrolledAccepts Medicare Assignment
855 JEFFERSON AVE UNIT 70, REDWOOD CITY, CA 94064(415) 968-9540(650) 550-9189 Get Directions Write a Review

NPPES record last updated: December 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 21, 2025, Apr 14, 2020 (2 updates tracked since 2020).

About Hadi Koesnodihardjo NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HADI KOESNODIHARDJO (NPI 1073735700) is an individual marriage & family therapist in Redwood City, California, licensed in California (MFC50900) and active in the NPI registry since May 2007. He is enrolled in Medicare PECOS and is a graduate of Other (2006).

NPPES Registry Identity

NPI1073735700
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameHADI KOESNODIHARDJO
Location Address855 JEFFERSON AVE UNIT 70Redwood City, CA 94064-7200
Mailing AddressPo Box 70Redwood City, CA 94064-0070 · (415) 968-9540 · Fax (650) 550-9189
Phone(415) 968-9540
Fax(650) 550-9189
Sole ProprietorYes
Medical School CMSOtherGraduated 2006
Enumeration DateMay 3, 2007
Last NPPES UpdateDecember 21, 20252 updates tracked since enumeration
NPPES CertifiedDecember 21, 2025
✔ NPI 1073735700 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFC50900
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
855 JEFFERSON AVE UNIT 70, Redwood City, CA 94064
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hadi Koesnodihardjo is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4587142146
PECOS Enrollment IDI20260204000812
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hadi Koesnodihardjo's NPI number?

The NPI number for Hadi Koesnodihardjo is 1073735700. It was assigned to this individual provider in the NPPES registry on May 3, 2007.

Where is Hadi Koesnodihardjo located?

Hadi Koesnodihardjo practices at 855 Jefferson Ave Unit 70, Redwood City, CA 94064. The listed phone number is (415) 968-9540.

What is Hadi Koesnodihardjo's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Hadi Koesnodihardjo enrolled in Medicare?

Yes. Hadi Koesnodihardjo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Hadi Koesnodihardjo was last updated on December 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.