Individual provider Active NPI

Alicia Nourse, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1194959015
Registry record updated May 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 39786 Issued in CA
Practice address
633 Cherry St
Santa Rosa, CA 95404-4202
Phone
(707) 526-0300
NPI assigned
May 6, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 6, 2009

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 39786 CA Primary

Addresses

Primary practice location

633 Cherry St
Santa Rosa, CA 95404-4202

Mailing address

PO Box 1074
Occidental, CA 95465-1074
Phone (707) 526-0300

Other names 1

  • Alice Nourse Former name

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
MFC 39786CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1241568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241568000000",
    "number": "1194959015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1074",
            "city": "OCCIDENTAL",
            "state": "CA",
            "postal_code": "954651074",
            "telephone_number": "707-526-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 CHERRY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044202",
            "telephone_number": "707-526-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOURSE",
        "first_name": "ALICIA",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-06",
        "last_updated": "2009-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 39786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICE",
            "last_name": "NOURSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 May 6, 2009; 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.