Active NPI
Marcia Lynn Dean
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1508919234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC22145
- Practice address
- 576 B St Ste 1a
Santa Rosa, CA 95401-5269 - Phone
- (650) 759-5493
- Fax
- (650) 343-9581
- NPI assigned
- Jan 18, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 22145 | CA | |
| Marriage & Family Therapist | 106H00000X | MFC22145 | CA | Primary |
Addresses
Primary practice location
576 B St Ste 1a
Santa Rosa, CA 95401-5269
Mailing address
576 B St Ste 1a
Santa Rosa, CA 95401-5269
Phone (650) 759-5493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22145 | CA | MD | Clinical Social Worker |
| MFC22145 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1668988800000",
"number": "1508919234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 B ST STE 1A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015269",
"telephone_number": "650-759-5493",
"fax_number": "650-343-9581"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 B ST STE 1A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015269",
"telephone_number": "650-759-5493",
"fax_number": "650-343-9581"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEAN",
"first_name": "MARCIA",
"middle_name": "LYNN",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-18",
"last_updated": "2022-11-21",
"certification_date": "2022-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "22145",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC22145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.