Active NPI
Jennifer Pearl Cruz
- Counselor
- Santa Rosa, CA
National Provider Identifier
1336389725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 634 Pressley St
Santa Rosa, CA 95404-5526 - Phone
- (707) 573-6955
- Fax
- (707) 479-1853
- NPI assigned
- Feb 25, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
634 Pressley St
Santa Rosa, CA 95404-5526
Mailing address
3925 Hoen Ave
Santa Rosa, CA 95405-7750
Phone (707) 508-9827
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4477 | Other | CA | MEDICAL |
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": "1235520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1336389725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 HOEN AVE",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954057750",
"telephone_number": "707-508-9827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "634 PRESSLEY ST",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954045526",
"telephone_number": "707-573-6955",
"fax_number": "707-479-1853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CRUZ",
"first_name": "JENNIFER",
"middle_name": "PEARL",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-25",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL",
"identifier": "4477",
"state": "CA"
}
],
"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 Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.