Individual provider Active NPI

Linda Collett, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1043574791
Registry record updated Jun 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
45886 Issued in CA
Practice address
4527 Montgomery Dr
Suite F
Santa Rosa, CA 95409-5363
Phone
(707) 322-8198
NPI assigned
Jun 27, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 27, 2012

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 45886 CA Primary

Addresses

Primary practice location

4527 Montgomery Dr
Suite F
Santa Rosa, CA 95409-5363

Mailing address

2524 Lakeview Dr
Santa Rosa, CA 95405-8667
Phone (707) 322-8198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 10, 2024 through Jan 10, 2028

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": "1340755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340755200000",
    "number": "1043574791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2524 LAKEVIEW DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954058667",
            "telephone_number": "707-322-8198"
        },
        {
            "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": "707-322-8198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLETT",
        "first_name": "LINDA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-27",
        "last_updated": "2012-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "45886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.