Active NPI
Jeremiah Watts
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1326471160
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF84037
- Practice address
- 2115 Lapper Ave
Santa Rosa, CA 95403-8127 - Phone
- (707) 453-6227
- NPI assigned
- Aug 15, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | IMF84037 | CA | Primary |
Addresses
Primary practice location
2115 Lapper Ave
Santa Rosa, CA 95403-8127
Mailing address
2045 W El Camino Ave Apt 509
Sacramento, CA 95833-1483
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
| License | State | Type | Specialty |
|---|---|---|---|
| IMF84037 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713312000000",
"number": "1326471160",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2045 W EL CAMINO AVE APT 509",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958331483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2115 LAPPER AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954038127",
"telephone_number": "707-453-6227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATTS",
"first_name": "JEREMIAH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-15",
"last_updated": "2024-04-17",
"certification_date": "2024-04-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF84037",
"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 Apr 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.