Thedoria D Ejimadu

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

114499 Issued in CA

Practice address

275 Beck Ave.
Fairfield, CA 94533

Phone

(707) 784-1934

NPI assigned

Sep 8, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

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": "1283904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680652800000",
    "number": "1417264755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2428 HOOFTRAIL WAY",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945318919",
            "telephone_number": "707-694-5677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BECK AVE.",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-784-1934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EJIMADU",
        "first_name": "THEDORIA",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-08",
        "last_updated": "2023-04-05",
        "certification_date": "2023-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417264755",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tdejimadu@solanocounty.com",
            "affiliation": "N",
            "address_1": "355 Tuolumne St",
            "city": "Vallejo",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945905700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Cecilia Ehman
• Mark Ehredt, RRW
• David Alan Ehrenfeld, M.D.
• Fatimeh Eid
• Donald Ray Eilert, D.C.
• Aaliyah Elahi
• Yoseph Elala
• Kaitlyn Dion Elam
• Victorino Elarmo
• Alexandra Ruth Elder, DMD

• Marriage & Family Therapist in Fairfield, CA
• Providers in Fairfield, 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 Apr 5, 2023; 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.