Mary Roanne De Guia Samuels, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

56303 Issued in CA

Practice address

704 Placer Circle
Vacaville, CA 95687

Phone

(707) 384-2815

NPI assigned

Oct 31, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Mary Roanne Samuels Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1225411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562025600000",
    "number": "1386897502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "704 PLACER CIRCLE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-384-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 PLACER CIRCLE",
            "city": "VACAVILLE",
            "state": "CA",
            "postal_code": "95687",
            "telephone_number": "707-384-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUELS",
        "first_name": "MARY ROANNE",
        "middle_name": "DE GUIA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-31",
        "last_updated": "2019-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "56303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "SAMUELS",
            "middle_name": "ROANNE",
            "prefix": "MRS.",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Ericka Samson, RN, ATC
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• Celia Maria Sanchez
• Emily Ann Sandau
• Bruce D. Sanders, PH.D.

• Marriage & Family Therapist in Vacaville, CA
• Providers in Vacaville, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.