MS. MATILDA ANN ST JOHN MFT
NPI 1093972457
Marriage & Family Therapist in Oakland, CA

Q: What is Matilda St John's NPI number?

The NPI number for Matilda St John is 1093972457. It was assigned to this individual provider in the NPPES registry on May 21, 2008.

Q: What is Matilda St John's specialty?

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

Q: Is Matilda St John enrolled in Medicare?

No. Matilda St John has opted out of Medicare through June 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Matilda St John was last updated on May 21, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.

Active since May 21, 2008Opted out of Medicare · through Jun 21, 2028

445 BELLEVUE AVE, STE 300, OAKLAND, CA 94610(510) 628-0877 Get Directions Write a Review

NPPES record last updated: May 21, 2008. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Ms. Matilda Ann St John Mft NPPES

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

MS. MATILDA ANN ST JOHN MFT (NPI 1093972457) is an individual marriage & family therapist in Oakland, California, licensed in California (MFC37114) and active in the NPI registry since May 2008. She has opted out of Medicare through June 21, 2028.

NPPES Registry Identity

NPI1093972457

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMS. MATILDA ANN ST JOHNCredential: MFT

Location Address445 BELLEVUE AVE, STE 300Oakland, CA 94610-4923

Mailing Address445 Bellevue Ave, Suite 300Oakland, CA 94610-4923 · (510) 628-0877

Phone(510) 628-0877

Sole ProprietorYes

Enumeration DateMay 21, 2008

✔ NPI 1093972457 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 · MFC37114

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.

445 BELLEVUE AVE, Oakland, CA 94610

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Matilda Ann St John Mft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 21, 2024 through June 21, 2028.

Opt-Out Effective DateJune 21, 2024

Opt-Out In Effect ThroughJune 21, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARIELLE BERG M.F.T.

Marriage & Family Therapist

445 BELLEVUE AVE, SUITE 104
OAKLAND, CA 94610

Alameda County (510) 594-4318

MR. JOHN LOUIS DEMELLO LCSW

Social Worker (Clinical)

445 BELLEVUE AVE, 300
OAKLAND, CA 94610

Alameda County (510) 532-8887

MAIA HUANG MFT

Marriage & Family Therapist

445 BELLEVUE AVE, SUITE 2
OAKLAND, CA 94610

Alameda County (510) 496-6020

DR. ERICA MEYERS PHD

Psychologist (Clinical)

445 BELLEVUE AVE, STE 201
OAKLAND, CA 94610

Alameda County (510) 832-0991

DAVID GAGE CUSHMAN PSY.D.

Psychologist (Clinical)

445 BELLEVUE AVE, SUITE 202
OAKLAND, CA 94610

Alameda County (415) 841-2481

MS. SIDNEY T. MULLEN MFT

Marriage & Family Therapist

445 BELLEVUE AVE, SUITE 303
OAKLAND, CA 94610

Alameda County (510) 893-7575

ELLEN POMPA MFT

Marriage & Family Therapist

445 BELLEVUE AVE, #101
OAKLAND, CA 94610

Alameda County (510) 915-0796

MS. ROSE PANICO PHELPS M.S., M.F.T.

Counselor (Mental Health)

445 BELLEVUE AVE, SUITE 104
OAKLAND, CA 94610

Alameda County (510) 658-4344

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 Matilda St John's NPI number?

The NPI number for Matilda St John is 1093972457. It was assigned to this individual provider in the NPPES registry on May 21, 2008.

Where is Matilda St John located?

Matilda St John practices at 445 Bellevue Ave Ste 300, Oakland, CA 94610. The listed phone number is (510) 628-0877.

What is Matilda St John's specialty?

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

Is Matilda St John enrolled in Medicare?

No. Matilda St John has opted out of Medicare through June 21, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Matilda St John was last updated on May 21, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.