Individual provider Active NPI

Carter John Haynes, MA, MFT, PH.D.

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1376565572
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 35717 Issued in CA
Practice address
3336 Bradshaw Rd
# 320
Sacramento, CA 95827-2615
Phone
(916) 267-1458
Fax
(916) 273-5641
NPI assigned
Jul 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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 MFC 35717 CA Primary

Addresses

Primary practice location

3336 Bradshaw Rd
# 320
Sacramento, CA 95827-2615

Mailing address

PO Box 276785
Sacramento, CA 95827-6785
Phone (916) 267-1458

Other identifiers 1

IdentifierTypeStateIssuer
MFC 35717OtherCAMFT LICSENSE

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
Credentials
Master of Arts, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MFC 35717CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1376565572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 276785",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958276785",
            "telephone_number": "916-267-1458",
            "fax_number": "916-273-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3336 BRADSHAW RD",
            "address_2": "# 320",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958272615",
            "telephone_number": "916-267-1458",
            "fax_number": "916-273-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "CARTER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "MA, MFT, PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 35717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MFT LICSENSE",
            "identifier": "MFC 35717",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2012; 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.