Active NPI
Martin Graff, MFT
- Marriage & Family Therapist
- Petaluma, CA
National Provider Identifier
1184106783
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 37756
- Practice address
- 855 Lakeville St Ste 108
Petaluma, CA 94952-7328 - Phone
- (707) 789-1664
- NPI assigned
- Aug 30, 2018
- Last updated
- Aug 30, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 | 37756 | CA | Primary |
Addresses
Primary practice location
855 Lakeville St Ste 108
Petaluma, CA 94952-7328
Mailing address
855 Lakeville St Ste 108
Petaluma, CA 94952-7328
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 37756 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
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 19, 2024 through Jan 19, 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": "1535587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535587200000",
"number": "1184106783",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "855 LAKEVILLE ST STE 108",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949527328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "855 LAKEVILLE ST STE 108",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949527328",
"telephone_number": "707-789-1664"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAFF",
"first_name": "MARTIN",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-08-30",
"last_updated": "2018-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "37756",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "37756",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.