Individual provider Active NPI

John Wiser, MFT

  • Marriage & Family Therapist
  • Fort Bragg, CA
National Provider Identifier
1538378484
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC36743 Issued in CA
Practice address
32670 Highway 20 Ste 2
Fort Bragg, CA 95437-5708
Phone
(707) 964-1136
NPI assigned
May 21, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC36743 CA Primary

Addresses

Primary practice location

32670 Highway 20 Ste 2
Fort Bragg, CA 95437-5708

Mailing address

790 S Franklin St Ste B
Fort Bragg, CA 95437-5456

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

LicenseStateTypeSpecialty
MFC36743CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1538378484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 S FRANKLIN ST STE B",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32670 HIGHWAY 20 STE 2",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "954375708",
            "telephone_number": "707-964-1136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WISER",
        "first_name": "JOHN",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-21",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Bragg, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; 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.