Individual provider Active NPI

Jared Anamin Ramos Vergara, MS

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1336660992
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121959 Issued in CA
Practice address
26 Hazelwood CT
Oakland, CA 94603-2132
Phone
(415) 517-1758
NPI assigned
Jul 3, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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 121959 CA Primary

Addresses

Primary practice location

26 Hazelwood CT
Oakland, CA 94603-2132

Mailing address

26 Hazelwood CT
Oakland, CA 94603-2132
Phone (415) 517-1758

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240827001512 CA Practitioner - Marriage and Family Therapist 8426597071 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Forward Wellness Family Therapy, Inc. CurrentSince Aug 13, 2024 Accepting new patients

Locations

1041 E Yorba Linda Blvd
Ste 202
Placentia, CA 92870
Phone (714) 579-0717

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1336660992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 HAZELWOOD CT",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032132",
            "telephone_number": "415-517-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 HAZELWOOD CT",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946032132",
            "telephone_number": "415-517-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAMOS VERGARA",
        "first_name": "JARED",
        "middle_name": "ANAMIN",
        "name_prefix": "Miss",
        "credential": "MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-03",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.