Individual provider Active NPI

Christy R Maxson, LMFT

  • Marriage & Family Therapist
  • Sonora, CA
National Provider Identifier
1255938122
Registry record updated Oct 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT117212 Issued in CA
Practice address
945 Morning Star Dr
Sonora, CA 95370-9249
Phone
(209) 536-8061
NPI assigned
Oct 5, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2020

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 MFT117212 CA Primary

Addresses

Primary practice location

945 Morning Star Dr
Sonora, CA 95370-9249

Mailing address

945 Morning Star Dr
Sonora, CA 95370-9249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFT117212CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1255938122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "945 MORNING STAR DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "945 MORNING STAR DR",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953709249",
            "telephone_number": "209-536-8061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAXSON",
        "first_name": "CHRISTY",
        "middle_name": "R",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT117212",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

Verify at the official NPI Registry.