Active NPI
Jose Carmen Estrada IX, LMFT
- Marriage & Family Therapist
- Vallejo, CA
National Provider Identifier
1225197767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 41051
- Practice address
- 355 Tuolumne St
Vallejo, CA 94590-5700 - Phone
- (707) 553-5810
- Fax
- (707) 553-5824
- NPI assigned
- Dec 8, 2006
- Sex
- Male
- 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 | 41051 | CA | Primary |
Addresses
Primary practice location
355 Tuolumne St
Vallejo, CA 94590-5700
Mailing address
1312 Jimeno LN
Woodland, CA 95695-5304
Phone (530) 406-1658
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
| License | State | Type | Specialty |
|---|---|---|---|
| 41051 | CA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311638400000",
"number": "1225197767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1312 JIMENO LN",
"city": "WOODLAND",
"state": "CA",
"postal_code": "956955304",
"telephone_number": "530-406-1658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "355 TUOLUMNE ST",
"city": "VALLEJO",
"state": "CA",
"postal_code": "945905700",
"telephone_number": "707-553-5810",
"fax_number": "707-553-5824"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "JOSE",
"middle_name": "CARMEN",
"name_prefix": "Mr.",
"name_suffix": "IX",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-08",
"last_updated": "2011-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "41051",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vallejo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.