Carol J Valencia

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT132321 Issued in CA

Practice address

1260 N Dutton Ave Ste 220
Santa Rosa, CA 95401-4686

Phone

(707) 568-2300

NPI assigned

Aug 19, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2022

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment
• Lifeworks of Sonoma County

  • Mental Health Counselor
  • Santa Rosa, CA
  • NPI 1063557171
  NPD
• North Bay Youth and Family Counseling, Inc.

  • Mental Health Counselor
  • Windsor, CA
  • NPI 1902601198
  NPD (past)

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

{
    "created_epoch": "1629331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1265108195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 MANKA CIR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954037752",
            "telephone_number": "707-235-7829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1260 N DUTTON AVE STE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014686",
            "telephone_number": "707-568-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "CAROL",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-19",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT132321",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1265108195",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.lifeworkssc.org/",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1260 N Dutton Ave Ste 220",
            "city": "Santa Rosa",
            "state": "CA",
            "country_code": "US",
            "postal_code": "954014686",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cecilia Cristina Valdovinos, LEP 4335
• Karen Teresa Lorena Valdovinos
• Michael Valdovinos, PSY.D.
• Dellon Vale, CMT, MLD-C
• Analila Valencia, ND, MSOM
• Joaquin Anibal Valencia
• Carlos Henrique Valente Moreira
• Renee G Valentino, P.T.
• Andrea Valenzuela
• Barbara Leigh Vall-Spinosa, MD

• Marriage & Family Therapist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.