Active NPI
Jacinta Rose-Marie Sutphin, AMFT
- Marriage & Family Therapist
- Albany, CA
National Provider Identifier
1235872037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 123578
- Practice address
- 1664 Solano Ave
Albany, CA 94707-2118 - Phone
- (707) 234-7049
- NPI assigned
- Apr 19, 2022
- Sex
- Female
- Sole proprietor
- Yes
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 | 123578 | CA | Primary |
Addresses
Primary practice location
1664 Solano Ave
Albany, CA 94707-2118
Mailing address
1664 Solano Ave
Albany, CA 94707-2118
Phone (707) 234-7049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 30, 2024 through Sep 30, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123578 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1650326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1650931200000",
"number": "1235872037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1664 SOLANO AVE",
"city": "ALBANY",
"state": "CA",
"postal_code": "947072118",
"telephone_number": "707-234-7049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1664 SOLANO AVE",
"city": "ALBANY",
"state": "CA",
"postal_code": "947072118",
"telephone_number": "707-234-7049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTPHIN",
"first_name": "JACINTA",
"middle_name": "ROSE-MARIE",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-04-19",
"last_updated": "2022-04-26",
"certification_date": "2022-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "123578",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Albany, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; 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.