Active NPI
Jacqueline Marie Eaton, MFT-I
- Marriage & Family Therapist
- Redwood City, CA
National Provider Identifier
1194152819
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF 74565
- Practice address
- 1727 Brewster Ave
Redwood City, CA 94062-1901 - Phone
- (165) 036-5784
- NPI assigned
- Sep 27, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 74565 | CA | Primary |
Addresses
Primary practice location
1727 Brewster Ave
Redwood City, CA 94062-1901
Mailing address
1727 Brewster Ave
Redwood City, CA 94062-1901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 9, 2024 through Jul 9, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 74565 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380240000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380240000000",
"number": "1194152819",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1727 BREWSTER AVE",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940621901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1727 BREWSTER AVE",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940621901",
"telephone_number": "165-036-5784"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EATON",
"first_name": "JACQUELINE",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "MFT-I",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-09-27",
"last_updated": "2013-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 74565",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.