Individual provider Active NPI

Eric Scott Douglass, LMFT

  • Marriage & Family Therapist
  • Visalia, CA
National Provider Identifier
1215017900
Registry record updated Jan 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 36483 Issued in CA
Practice address
1910 S Court St
Visalia, CA 93277-5426
Phone
(559) 627-3775
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2019

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 36483 CA Primary

Addresses

Primary practice location

1910 S Court St
Visalia, CA 93277-5426

Mailing address

1910 S Court St
Visalia, CA 93277-5426
Phone (559) 627-3775

Other practice location 1

1393 Bailey St
Hanford, CA 93230
Phone (559) 582-4481 ext. 199

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
I20240202001860 CA Practitioner - Marriage and Family Therapist 6800249186 Practice locations: Visalia, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1910 S Court St
Visalia, CA 93277-5426
Phone (559) 627-3775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC 36483CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546992000000",
    "number": "1215017900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 S COURT ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775426",
            "telephone_number": "559-627-3775",
            "fax_number": "559-627-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S COURT ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932775426",
            "telephone_number": "559-627-3775"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1393 Bailey St",
            "address_purpose": "LOCATION",
            "city": "Hanford",
            "state": "CA",
            "postal_code": "93230",
            "country_code": "US",
            "telephone_number": "559-582-4481 x199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "ERIC",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2019-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 36483",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Visalia, CA

Sources for this page

Verify at the official NPI Registry.