Active NPI
Trista Jean Samole, M.S.
- Professional Counselor
- Sebastopol, CA
National Provider Identifier
1194031328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 19693
- Practice address
- 339 S Main St
Sebastopol, CA 95472-4208 - Phone
- (720) 987-9426
- NPI assigned
- Aug 25, 2010
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | |||
| Professional Counselor | 101YP2500X | 19693 | CA | Primary |
| Counselor | 101Y00000X | CA |
Addresses
Primary practice location
339 S Main St
Sebastopol, CA 95472-4208
Mailing address
339 S Main St
Sebastopol, CA 95472-4208
Phone (720) 987-9426
Other practice location 1
8931 Huron St
Thornton, CO 80260-6806
Phone (303) 853-3654
Other practice location 2
1360 N Dutton Ave Ste C
Santa Rosa, CA 95401-4668
Phone (707) 569-0877
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19693 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757635200000",
"number": "1194031328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "339 S MAIN ST",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724208",
"telephone_number": "720-987-9426"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "339 S MAIN ST",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724208",
"telephone_number": "720-987-9426"
}
],
"practiceLocations": [
{
"address_1": "8931 Huron St",
"address_purpose": "LOCATION",
"city": "Thornton",
"state": "CO",
"postal_code": "802606806",
"country_code": "US",
"telephone_number": "303-853-3654",
"fax_number": "303-853-3656",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1360 N Dutton Ave Ste C",
"address_purpose": "LOCATION",
"city": "Santa Rosa",
"state": "CA",
"postal_code": "954014668",
"country_code": "US",
"telephone_number": "707-569-0877",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SAMOLE",
"first_name": "TRISTA",
"middle_name": "JEAN",
"credential": "M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-25",
"last_updated": "2025-09-12",
"certification_date": "2025-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "19693",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "CA",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.