Individual provider Active NPI

Haley Gibson, LMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1407604259
Registry record updated Apr 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
162595 Issued in CA
Practice address
3434 Mendocino Ave # a
Santa Rosa, CA 95403-2274
Phone
(707) 284-1978
Fax
(707) 708-2188
NPI assigned
May 7, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 13, 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 162595 CA Primary

Addresses

Primary practice location

3434 Mendocino Ave # a
Santa Rosa, CA 95403-2274

Mailing address

615 Healdsburg Ave Unit 221
Santa Rosa, CA 95401-5168
Phone (925) 282-0402

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
162595CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sonoma County Child & Family Counseling, Inc. PastSince May 12, 2024 Accepting new patients
Sonoma County Child & Family Counseling, Inc. Marriage & Family Therapist PastSince May 12, 2024 Accepting new patients

Organizations & group practices 2

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": "1715040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776038400000",
    "number": "1407604259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 HEALDSBURG AVE UNIT 221",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954015168",
            "telephone_number": "925-282-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3434 MENDOCINO AVE # A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954032274",
            "telephone_number": "707-284-1978",
            "fax_number": "707-708-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "HALEY",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-07",
        "last_updated": "2026-04-13",
        "certification_date": "2026-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "162595",
            "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 Apr 13, 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.