Active NPI
Jamie Blake Maxwell, LMFT
- Marriage & Family Therapist
- Grass Valley, CA
National Provider Identifier
1073877684
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT99607
- Practice address
- 500 Crown Point Cir Ste 120
Grass Valley, CA 95945-9561 - Phone
- (530) 470-2542
- NPI assigned
- Jun 28, 2012
- Sex
- Female
- Sole proprietor
- No
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 | LMFT99607 | CA | Primary |
Addresses
Primary practice location
500 Crown Point Cir Ste 120
Grass Valley, CA 95945-9561
Mailing address
PO Box 2773
Sacramento, CA 95812-2773
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
| License | State | Type | Specialty |
|---|---|---|---|
| LMFT99607 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Forensic Psychology Associates, Inc | Marriage & Family Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Adult Mental Health Clinic/Center
- Pico Rivera, CA
- NPI 1396929022
Marriage & Family Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658793600000",
"number": "1073877684",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2773",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958122773"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 CROWN POINT CIR STE 120",
"city": "GRASS VALLEY",
"state": "CA",
"postal_code": "959459561",
"telephone_number": "530-470-2542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAXWELL",
"first_name": "JAMIE",
"middle_name": "BLAKE",
"name_prefix": "Ms.",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-28",
"last_updated": "2022-07-26",
"certification_date": "2022-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT99607",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grass Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.