Individual provider Active NPI

Jaime Chapman

  • Addiction (Substance Use Disorder) Counselor
  • Santa Rosa, CA
National Provider Identifier
1104696038
Registry record updated Mar 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
490047AN Issued in CA
Practice address
540 Middle Rincon Rd
Santa Rosa, CA 95409-3107
Phone
(707) 228-7667
NPI assigned
Jan 2, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 490047AN CA Primary

Addresses

Primary practice location

540 Middle Rincon Rd
Santa Rosa, CA 95409-3107

Mailing address

4934 Sunshine Ave
Santa Rosa, CA 95409-2660
Phone (916) 968-5048

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
490047ANCAMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1704153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1104696038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4934 SUNSHINE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092660",
            "telephone_number": "916-968-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 MIDDLE RINCON RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954093107",
            "telephone_number": "707-228-7667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN",
        "first_name": "JAIME",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-02",
        "last_updated": "2024-03-29",
        "certification_date": "2024-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "490047AN",
            "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 29, 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.