Active NPI
Sara Jeanne Fawkes, M.A., LPPC
- Professional Counselor
- Concord, CA
National Provider Identifier
1487145108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC4603
- Practice address
- 963 San Simeon Dr
Concord, CA 94518-2158 - Phone
- (925) 286-1304
- NPI assigned
- May 29, 2018
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPCC4603 | CA | Primary |
Addresses
Primary practice location
963 San Simeon Dr
Concord, CA 94518-2158
Mailing address
963 San Simeon Dr
Concord, CA 94518-2158
Phone (925) 286-1304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Mar 26, 2024 through Mar 26, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPCC4603 | CA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527552000000",
"number": "1487145108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "963 SAN SIMEON DR",
"city": "CONCORD",
"state": "CA",
"postal_code": "945182158",
"telephone_number": "925-286-1304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "963 SAN SIMEON DR",
"city": "CONCORD",
"state": "CA",
"postal_code": "945182158",
"telephone_number": "925-286-1304"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FAWKES",
"first_name": "SARA",
"middle_name": "JEANNE",
"credential": "M.A., LPPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-05-29",
"last_updated": "2018-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPCC4603",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.