Active NPI
Dawn Wade, MA, LMFT, ATR, CHT
- Marriage & Family Therapist
- Rocklin, CA
National Provider Identifier
1497181580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 53765
- Practice address
- 3175 Sunset Blvd
Suite 104 a
Rocklin, CA 95677-3091 - Phone
- (916) 905-4278
- Fax
- (510) 350-9034
- NPI assigned
- Sep 19, 2013
- 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 | 53765 | CA | Primary |
Addresses
Primary practice location
3175 Sunset Blvd
Suite 104 a
Rocklin, CA 95677-3091
Mailing address
3175 Sunset Blvd
Suite 104B
Rocklin, CA 95677-3091
Phone (916) 905-4278
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53765 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1379548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379548800000",
"number": "1497181580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3175 SUNSET BLVD",
"address_2": "SUITE 104B",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956773091",
"telephone_number": "916-905-4278",
"fax_number": "510-350-9034"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3175 SUNSET BLVD",
"address_2": "SUITE 104 A",
"city": "ROCKLIN",
"state": "CA",
"postal_code": "956773091",
"telephone_number": "916-905-4278",
"fax_number": "510-350-9034"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WADE",
"first_name": "DAWN",
"credential": "MA, LMFT, ATR, CHT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-09-19",
"last_updated": "2013-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "53765",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rocklin, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.