Individual provider Active NPI

Deborah Jean Keith, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1326189549
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC25606 Issued in CA
Practice address
4900 Montecito Ave
Santa Rosa, CA 95404-1939
Phone
(707) 573-5817
NPI assigned
Feb 9, 2007
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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 MFC25606 CA Primary

Addresses

Primary practice location

4900 Montecito Ave
Santa Rosa, CA 95404-1939

Mailing address

4900 Montecito Ave
Santa Rosa, CA 95404-1939
Phone (707) 235-6602

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
MFC25606CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1326189549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 MONTECITO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041939",
            "telephone_number": "707-235-6602",
            "fax_number": "707-573-5817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 MONTECITO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041939",
            "telephone_number": "707-573-5817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEITH",
        "first_name": "DEBORAH",
        "middle_name": "JEAN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC25606",
            "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 Aug 14, 2019; 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.