Active NPI
Nicole Denise Loggins Desamparo, MFTI
- Marriage & Family Therapist
- Pleasant Hill, CA
National Provider Identifier
1396896213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC48275
- Practice address
- 399 Taylor Blvd
Suite 210
Pleasant Hill, CA 94523-2297 - Phone
- (925) 482-6215
- NPI assigned
- Jan 16, 2007
- Last updated
- Aug 12, 2014
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF 49753 | CA | |
| Marriage & Family Therapist | 106H00000X | MFC48275 | CA | Primary |
Addresses
Primary practice location
399 Taylor Blvd
Suite 210
Pleasant Hill, CA 94523-2297
Mailing address
399 Taylor Blvd
Suite 210
Pleasant Hill, CA 94523-2297
Phone (925) 482-6215
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4831 | Other | CA | MEDI-CAL STAFF NUMBER |
Other names 1
- Nicole Denise Loggins
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Previously, effective Sep 23, 2024 through Sep 23, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMF 49753 | CA | MD | Marriage & Family Therapist |
| MFC48275 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407801600000",
"number": "1396896213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 TAYLOR BLVD",
"address_2": "SUITE 210",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945232297",
"telephone_number": "925-482-6215"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 TAYLOR BLVD",
"address_2": "SUITE 210",
"city": "PLEASANT HILL",
"state": "CA",
"postal_code": "945232297",
"telephone_number": "925-482-6215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESAMPARO",
"first_name": "NICOLE",
"middle_name": "DENISE LOGGINS",
"credential": "MFTI",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2014-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF 49753",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC48275",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL STAFF NUMBER",
"identifier": "4831",
"state": "CA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "NICOLE",
"last_name": "LOGGINS",
"middle_name": "DENISE",
"credential": "LMFT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Pleasant Hill, CA
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- Medha Patel Desai, DDS
- Rujul Rakeshkumar Desai, MD
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.