Individual provider Active NPI

Jenifer Pace, MFT

  • Marriage & Family Therapist
  • Eureka, CA
National Provider Identifier
1306921655
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
41307 Issued in CA
Practice address
2625 Wilson St
Eureka, CA 95503-4829
Phone
(707) 443-1069
Fax
(707) 444-1498
NPI assigned
Oct 26, 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 41307 CA Primary

Addresses

Primary practice location

2625 Wilson St
Eureka, CA 95503-4829

Mailing address

2625 Wilson St
Eureka, CA 95503-4829
Phone (707) 443-1069

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306921655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 WILSON ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034829",
            "telephone_number": "707-443-1069",
            "fax_number": "707-444-1498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2625 WILSON ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955034829",
            "telephone_number": "707-443-1069",
            "fax_number": "707-444-1498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "JENIFER",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "41307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.