Individual provider Active NPI

Phyllis Grannis, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1386496933
Registry record updated Aug 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
28437 Issued in CA
Practice address
506 Corlano Ave
Santa Rosa, CA 95404-5227
Phone
(707) 495-1968
NPI assigned
Apr 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2026

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 28437 CA Primary

Addresses

Primary practice location

506 Corlano Ave
Santa Rosa, CA 95404-5227

Mailing address

506 Corlano Ave
Santa Rosa, CA 95404-5227
Phone (707) 495-1968

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
28437CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787529600000",
    "number": "1386496933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "506 CORLANO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045227",
            "telephone_number": "707-495-1968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "506 CORLANO AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045227",
            "telephone_number": "707-495-1968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANNIS",
        "first_name": "PHYLLIS",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-04",
        "last_updated": "2026-08-24",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "28437",
            "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 24, 2026; 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.