Individual provider Active NPI

Charlotte Anne Fess, LMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1205185337
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT93267 Issued in CA
Practice address
576 B St Ste 1a
Santa Rosa, CA 95401-5269
Phone
(707) 595-3012
NPI assigned
Sep 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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 LMFT93267 CA Primary

Addresses

Primary practice location

576 B St Ste 1a
Santa Rosa, CA 95401-5269

Mailing address

PO Box 198
Santa Rosa, CA 95402-0198

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240722001917 CA Practitioner - Marriage and Family Therapist 0749726115 Practice locations: Santa Rosa, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

576 B St
Suite 1a
Santa Rosa, CA 95401-5269
Phone (707) 595-3012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT93267CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1205185337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954020198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 B ST STE 1A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015269",
            "telephone_number": "707-595-3012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FESS",
        "first_name": "CHARLOTTE",
        "middle_name": "ANNE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT93267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.