Individual provider Active NPI

Analiese Faith Logan

  • Marriage & Family Therapist
  • Fairfield, CA
National Provider Identifier
1023824489
Registry record updated Dec 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
370 Tabor Ave
Fairfield, CA 94533-8411
Phone
(909) 774-6717
NPI assigned
Dec 9, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

370 Tabor Ave
Fairfield, CA 94533-8411

Mailing address

370 Tabor Ave
Fairfield, CA 94533-8411
Phone (909) 774-6717

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

NPI Registry JSON

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

{
    "created_epoch": "1733702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733702400000",
    "number": "1023824489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 TABOR AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338411",
            "telephone_number": "909-774-6717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 TABOR AVE",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945338411",
            "telephone_number": "909-774-6717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "ANALIESE",
        "middle_name": "FAITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-09",
        "last_updated": "2024-12-09",
        "certification_date": "2024-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2024; 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.