Missing Elements

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

IMF55305 Issued in CA

Legal business name

MISSING ELEMENTS

Practice address

1717 Yulupa Ave Ste 5
Santa Rosa, CA 95405-6201

Phone

(707) 560-1051

Fax

(866) 803-4979

NPI assigned

Nov 8, 2012

Organization subpart

No

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

Authorized official

Name

Suze Cribbs, LMFTNPI 1629448485

Title

Clinical Director

Phone

(707) 560-1051

Specialties & licenses 3

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Suze Cribbs, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
  • NPI 1629448485
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711929600000",
    "number": "1487908620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954020882",
            "telephone_number": "707-560-1051",
            "fax_number": "866-803-4979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 YULUPA AVE STE 5",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954056201",
            "telephone_number": "707-560-1051",
            "fax_number": "866-803-4979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSING ELEMENTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-08",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A",
        "authorized_official_last_name": "CRIBBS",
        "authorized_official_first_name": "SUZE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "707-560-1051",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "IMF55305",
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Homa Zarghani Mirzazadeh
• Susann Mischke, NP
• Mishel Malhotra DMD Dental Corp
• Monte Mishler
• Michael G Missakian, PHARM.D./PH.D.
• Alaina Mitchell
• Christine Mink Mitchell, RN
• Laurie Mitchell
• Miles F. Mitchell, MD
• Steven A Mitnick, MD

• Community/Behavioral Health Agency in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2024; 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.