MS. KRISTYN NICOLE TANAKA-ROCHE MFT, ATR - NPI 1124333968 - Marriage & Family Therapist in San Jose, CA

Q: What is Kristyn Tanaka-roche's NPI number?

The NPI number for Kristyn Tanaka-roche is 1124333968. It was assigned to this individual provider in the NPPES registry on August 17, 2010.

Q: What is Kristyn Tanaka-roche's specialty?

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

Q: Is Kristyn Tanaka-roche enrolled in Medicare?

No. Kristyn Tanaka-roche has opted out of Medicare through September 11, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

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About Ms. Kristyn Nicole Tanaka-roche Mft, Atr NPPES

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

MS. KRISTYN NICOLE TANAKA-ROCHE MFT, ATR (NPI 1124333968) is an individual marriage & family therapist in San Jose, California, licensed in California (82006) and active in the NPI registry since August 2010. She has opted out of Medicare through September 11, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1124333968

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMS. KRISTYN NICOLE TANAKA-ROCHECredential: MFT, ATR

Location Address3880 S BASCOM AVE STE 115San Jose, CA 95124-2600

Mailing Address3880 S Bascom Ave Ste 115San Jose, CA 95124-2600

Phone(408) 351-1044

Sole ProprietorNo

Enumeration DateAugust 17, 2010

Last NPPES UpdateOctober 15, 2021

NPPES CertifiedOctober 15, 2021

✔ NPI 1124333968 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 · 82006

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.

3880 S BASCOM AVE STE 115, San Jose, CA 95124

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

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Opted out of Medicare

Ms. Kristyn Nicole Tanaka-roche Mft, Atr 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 September 11, 2024 through September 11, 2026.

Opt-Out Effective DateSeptember 11, 2024

Opt-Out In Effect ThroughSeptember 11, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 9

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

CHILD & FAMILY COUNSELING GROUP

Marriage & Family Therapist