Active NPI
Jorge Luis Camacho Zepeda
- Marriage & Family Therapist
- Santa Maria, CA
National Provider Identifier
1477196152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- AMFT111708
- Practice address
- 1919 Sandalwood Dr
Santa Maria, CA 93455-2863 - Phone
- (805) 406-4000
- NPI assigned
- Oct 24, 2019
- Last updated
- Oct 24, 2019
- Sex
- Male
- 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 | AMFT111708 | CA | Primary |
Addresses
Primary practice location
1919 Sandalwood Dr
Santa Maria, CA 93455-2863
Mailing address
1919 Sandalwood Dr
Santa Maria, CA 93455-2863
Phone (805) 406-4000
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 |
|---|---|---|---|
| AMFT111708 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1571875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1571875200000",
"number": "1477196152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 SANDALWOOD DR",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934552863",
"telephone_number": "805-406-4000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 SANDALWOOD DR",
"city": "SANTA MARIA",
"state": "CA",
"postal_code": "934552863",
"telephone_number": "805-406-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO ZEPEDA",
"first_name": "JORGE",
"middle_name": "LUIS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-10-24",
"last_updated": "2019-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "AMFT111708",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Maria, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.