Active NPI
Christine Dufond
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1013303536
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 53645
- Practice address
- 4527 Montgomery Dr
Suite F
Santa Rosa, CA 95409-5363 - Phone
- (707) 483-8232
- NPI assigned
- Apr 10, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 53645 | CA | Primary |
Addresses
Primary practice location
4527 Montgomery Dr
Suite F
Santa Rosa, CA 95409-5363
Mailing address
2902 Yulupa Ave
Santa Rosa, CA 95405-8695
Phone (707) 483-8232
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241112000542 | CA | Practitioner - Marriage and Family Therapist | 7911431150 | Practice locations: Sebastopol, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53645 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1428624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1428624000000",
"number": "1013303536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2902 YULUPA AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954058695",
"telephone_number": "707-483-8232"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4527 MONTGOMERY DR",
"address_2": "SUITE F",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954095363",
"telephone_number": "707-483-8232"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUFOND",
"first_name": "CHRISTINE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-04-10",
"last_updated": "2015-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "53645",
"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 Apr 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.