Individual provider Active NPI

Jessica Jazmin Arzate Pelayo, BA IN SOCIAL WORK

  • Mental Health Counselor
  • Sebastopol, CA
National Provider Identifier
1255127247
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1800 Hwy 116 N BLDG a
Sebastopol, CA 95472-2607
Phone
(707) 823-7300
NPI assigned
Apr 16, 2025
Last updated
Apr 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1800 Hwy 116 N BLDG a
Sebastopol, CA 95472-2607

Mailing address

1800 Hwy 116 N
Sebastopol, CA 95472-2607
Phone (707) 823-7300

Other practice location 1

1 Chelsea Cir
Cloverdale, CA 95425-4002
Phone (707) 527-2460

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

Practice roles

OrganizationSpecialtyStatusNew patients
TLC Child and Family Services Mental Health Current Accepting new patients

Locations

1800 Hwy 116 N
Sebastopol, CA 95472
Phone (707) 634-9070

1800 Hwy 116 N
Bldg A
Sebastopol, CA 95472
Phone (707) 823-7300

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1744761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744761600000",
    "number": "1255127247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 HWY 116 N",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-823-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 HWY 116 N BLDG A",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954722607",
            "telephone_number": "707-823-7300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Chelsea Cir",
            "address_purpose": "LOCATION",
            "city": "Cloverdale",
            "state": "CA",
            "postal_code": "954254002",
            "country_code": "US",
            "telephone_number": "707-527-2460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ARZATE PELAYO",
        "first_name": "JESSICA",
        "middle_name": "JAZMIN",
        "credential": "BA  IN SOCIAL WORK",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-16",
        "last_updated": "2025-04-16",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.