Individual provider Active NPI

Quenby Lel Gallahan, LMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1043670128
Registry record updated Mar 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 52980 Issued in CA
Practice address
1521 Fair Oaks CT
Santa Rosa, CA 95404-4025
Phone
(707) 526-5629
NPI assigned
Mar 2, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2016

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 MFC 52980 CA Primary

Addresses

Primary practice location

1521 Fair Oaks CT
Santa Rosa, CA 95404-4025

Mailing address

PO Box 4605
Santa Rosa, CA 95402-4605
Phone (707) 526-5629

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

State licenses

LicenseStateTypeSpecialty
MFC 52980CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1456876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456876800000",
    "number": "1043670128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4605",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954024605",
            "telephone_number": "707-526-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1521 FAIR OAKS CT",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044025",
            "telephone_number": "707-526-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAHAN",
        "first_name": "QUENBY",
        "middle_name": "LEL",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-02",
        "last_updated": "2016-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 52980",
            "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 Mar 2, 2016; 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.