Individual provider Active NPI

Julie Ann Green, M.S., M.F.T.

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1285798009
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC33953 Issued in CA
Practice address
2460 W 3Rd St
Suite 220
Santa Rosa, CA 95401-6409
Phone
(707) 795-0200
Fax
(707) 795-0200
NPI assigned
Dec 19, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC33953 CA Primary

Addresses

Primary practice location

2460 W 3Rd St
Suite 220
Santa Rosa, CA 95401-6409

Mailing address

2460 W 3Rd St
Suite 220
Santa Rosa, CA 95401-6409
Phone (707) 795-0200

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFC33953CAMDMarriage & Family Therapist
33953CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285798009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2460 W 3RD ST",
            "address_2": "SUITE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016409",
            "telephone_number": "707-795-0200",
            "fax_number": "707-795-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2460 W 3RD ST",
            "address_2": "SUITE 220",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954016409",
            "telephone_number": "707-795-0200",
            "fax_number": "707-795-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "name_prefix": "Miss",
        "credential": "M.S., M.F.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC33953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.