Individual provider Active NPI

Angela Yolanda Vazquez, B.A., M.A.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1013227172
Registry record updated Nov 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
123018 Issued in CA
Practice address
341 Irwin LN
Santa Rosa, CA 95401-5603
Phone
(707) 494-6628
NPI assigned
Oct 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 123018 CA Primary

Addresses

Primary practice location

341 Irwin LN
Santa Rosa, CA 95401-5603

Mailing address

341 Irwin LN
Santa Rosa, CA 95401-5603
Phone (707) 494-6628

Other practice location 1

2258 Tokay St
Santa Rosa, CA 95404-6193
Phone (707) 494-6628

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
Credentials
Bachelor of Arts, Master of Arts

State licenses

LicenseStateTypeSpecialty
123018CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605830400000",
    "number": "1013227172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 IRWIN LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015603",
            "telephone_number": "707-494-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 IRWIN LN",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015603",
            "telephone_number": "707-494-6628"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2258 Tokay St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954046193",
            "country_code": "US",
            "telephone_number": "707-494-6628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VAZQUEZ",
        "first_name": "ANGELA",
        "middle_name": "YOLANDA",
        "name_prefix": "Mrs.",
        "credential": "B.A., M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-07",
        "last_updated": "2020-11-20",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "123018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.