Individual provider Active NPI

Pamela A Boaz, PHD MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1033127972
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT19314 Issued in CA
Practice address
659 Cherry St
Santa Rosa, CA 95404-4202
Phone
(707) 526-8300
Fax
(707) 526-8310
NPI assigned
Aug 4, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY16196 CA
Marriage & Family Therapist 106H00000X MFT19314 CA Primary

Addresses

Primary practice location

659 Cherry St
Santa Rosa, CA 95404-4202

Mailing address

659 Cherry St
Santa Rosa, CA 95404-4202
Phone (707) 526-8300

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PSY16196CAMDClinical Psychologist
MFT19314CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1033127972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-526-8300",
            "fax_number": "707-526-8310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "659 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-526-8300",
            "fax_number": "707-526-8310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOAZ",
        "first_name": "PAMELA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "PHD MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-04",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY16196",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT19314",
            "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 Sep 11, 2025; 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.