Active NPI
Jeramy A Sanquist, MFT
- Marriage & Family Therapist
- Rialto, CA
National Provider Identifier
1477743235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 50980
- Practice address
- 850 E Foothill Blvd
Rialto, CA 92376-5230 - Phone
- (909) 421-4678
- Fax
- (909) 421-9258
- NPI assigned
- Jul 27, 2007
- Last updated
- Aug 22, 2016
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MFC 50980 | CA | |
| Marriage & Family Therapist | 106H00000X | 50980 | CA | Primary |
Addresses
Primary practice location
850 E Foothill Blvd
Rialto, CA 92376-5230
Mailing address
850 E Foothill Blvd
Rialto, CA 92376-5230
Phone (909) 421-4678
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000 | Other | CA | MHSA |
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 |
|---|---|---|---|
| MFC 50980 | CA | MD | Mental Health Counselor |
| 50980 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471824000000",
"number": "1477743235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 E FOOTHILL BLVD",
"city": "RIALTO",
"state": "CA",
"postal_code": "923765230",
"telephone_number": "909-421-4678",
"fax_number": "909-421-9258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 E FOOTHILL BLVD",
"city": "RIALTO",
"state": "CA",
"postal_code": "923765230",
"telephone_number": "909-421-4678",
"fax_number": "909-421-9258"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANQUIST",
"first_name": "JERAMY",
"middle_name": "A",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-27",
"last_updated": "2016-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "MFC 50980",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "50980",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MHSA",
"identifier": "0000",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rialto, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.