Active NPI
Etty Garber, MFCT
- Marriage & Family Therapist
- Groveland, CA
National Provider Identifier
1467776500
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- M14629
- Practice address
- 12699 Cresthaven Dr
Groveland, CA 95321-9520 - Phone
- (209) 962-5205
- NPI assigned
- Mar 18, 2010
- Last updated
- Mar 18, 2010
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | M14629 | CA | Primary |
Addresses
Primary practice location
12699 Cresthaven Dr
Groveland, CA 95321-9520
Mailing address
12699 Cresthaven Dr
Groveland, CA 95321-9520
Phone (209) 962-5205
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
| License | State | Type | Specialty |
|---|---|---|---|
| M14629 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268870400000",
"number": "1467776500",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12699 CRESTHAVEN DR",
"city": "GROVELAND",
"state": "CA",
"postal_code": "953219520",
"telephone_number": "209-962-5205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12699 CRESTHAVEN DR",
"city": "GROVELAND",
"state": "CA",
"postal_code": "953219520",
"telephone_number": "209-962-5205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARBER",
"first_name": "ETTY",
"name_prefix": "Dr.",
"credential": "MFCT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-18",
"last_updated": "2010-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "M14629",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Groveland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.