Individual provider Active NPI

Jessica Ada Duke, M.A., LMFT

  • Marriage & Family Therapist
  • Eureka, CA
National Provider Identifier
1184765265
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 53194 Issued in CA
Practice address
720 Wood St
Eureka, CA 95501-4413
Phone
(707) 268-2935
Fax
(707) 476-4071
NPI assigned
Feb 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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 53194 CA Primary

Addresses

Primary practice location

720 Wood St
Eureka, CA 95501-4413

Mailing address

720 Wood St
Eureka, CA 95501-4413
Phone (707) 268-2935

Other practice location 1

134 D St
Suite 301
Eureka, CA 95501-0455
Phone (707) 476-2267

Other identifiers 7

IdentifierTypeStateIssuer
4601MedicaidCA
16105MedicaidCA
6814-FSPMedicaidCA
4674MedicaidCA
6814KMedicaidCA
16735MedicaidCA
4605MedicaidCA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jduke@co.humboldt.ca.us

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC 53194CAMDMarriage & Family Therapist
53194CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Humboldt Current Accepting new patients
County of Humboldt CurrentSince Nov 21, 2024 Accepting new patients
County of Humboldt CurrentSince Nov 21, 2024 Accepting new patients

Locations

720 Wood St
Eureka, CA 95501
Phone (707) 268-2900

720 Wood St
Rm 209
Eureka, CA 95501

Organizations & group practices 3

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": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1184765265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2935",
            "fax_number": "707-476-4071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 WOOD ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014413",
            "telephone_number": "707-268-2935",
            "fax_number": "707-476-4071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "134 D St",
            "address_2": "Suite 301",
            "address_purpose": "LOCATION",
            "city": "Eureka",
            "state": "CA",
            "postal_code": "955010455",
            "country_code": "US",
            "telephone_number": "707-476-2267",
            "fax_number": "707-476-1299",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUKE",
        "first_name": "JESSICA",
        "middle_name": "ADA",
        "name_prefix": "Ms.",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 53194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4601",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16105",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6814-FSP",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4674",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6814K",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16735",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4605",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jduke@co.humboldt.ca.us",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "address_1": "720 Wood St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014413",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Eureka, CA

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