Individual provider Active NPI

Ciera Nicole Perez, AMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1255179875
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138382 Issued in CA
Practice address
1023 4TH St
Santa Rosa, CA 95404-4301
Phone
(707) 569-6053
NPI assigned
Jul 17, 2024
Last updated
Jul 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 138382 CA Primary

Addresses

Primary practice location

1023 4TH St
Santa Rosa, CA 95404-4301

Mailing address

328 Yates Dr
Santa Rosa, CA 95405-4705
Phone (707) 494-6194

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

LicenseStateTypeSpecialty
138382CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mealani Smith Licensed Clinical Social Worker PC CurrentSince Jul 21, 2024 Accepting new patients

Locations

1023 4th St
Santa Rosa, CA 95404
Phone (707) 280-1194

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": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1255179875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 YATES DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954054705",
            "telephone_number": "707-494-6194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 4TH ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044301",
            "telephone_number": "707-569-6053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "CIERA",
        "middle_name": "NICOLE",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-17",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.