Individual provider Active NPI

Zachary S Simons

  • Marriage & Family Therapist
  • Ukiah, CA
National Provider Identifier
1093419806
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
149288 Issued in CA
Practice address
169 Mason St Ste 300
Ukiah, CA 95482-4483
Phone
(707) 463-0405
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 149288 CA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

169 Mason St Ste 300
Ukiah, CA 95482-4483

Mailing address

410 Jones St Ste C1
Ukiah, CA 95482-5491
Phone (707) 463-0405

Other practice location 1

564 S Dora St Ste D
Ukiah, CA 95482-5465
Phone (707) 463-0405

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
149288CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tapestry Family Services, Inc. CurrentSince Apr 1, 2023 Accepting new patients
Manzanita Services Inc. PastSince Apr 1, 2023 Accepting new patients

Locations

564 S Dora St
Ste D
Ukiah, CA 95482
Phone (707) 472-0362

169 Mason St
Ste 300
Ukiah, CA 95482
Phone (707) 463-3000

410 Jones St
Ste C1
Ukiah, CA 95482

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1093419806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 JONES ST STE C1",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825491",
            "telephone_number": "707-463-0405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 MASON ST STE 300",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954824483",
            "telephone_number": "707-463-0405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "564 S Dora St Ste D",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954825465",
            "country_code": "US",
            "telephone_number": "707-463-0405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "ZACHARY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149288",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ukiah, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.