Active NPI
Jay Rebert, MFT
- Marriage & Family Therapist
- Fair Oaks, CA
National Provider Identifier
1245348093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 40170
- Practice address
- 11622 Fair Oaks Blvd
Suite 103
Fair Oaks, CA 95628 - Phone
- (916) 241-5035
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- 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 | 40170 | CA | Primary |
Addresses
Primary practice location
11622 Fair Oaks Blvd
Suite 103
Fair Oaks, CA 95628
Mailing address
8593 Kermes Ave
Fair Oaks, CA 95628
Phone (916) 241-9446
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318291200000",
"number": "1245348093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8593 KERMES AVE",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "95628",
"telephone_number": "916-241-9446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11622 FAIR OAKS BLVD",
"address_2": "SUITE 103",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "95628",
"telephone_number": "916-241-5035"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REBERT",
"first_name": "JAY",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-29",
"last_updated": "2011-10-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "40170",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fair Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.