Individual provider Active NPI

M. Patricia Graef, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1568856169
Registry record updated Aug 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
85666 Issued in CA
Practice address
360 Tesconi Cir Ste C
Santa Rosa, CA 95401
Phone
(510) 459-8137
NPI assigned
Mar 23, 2015
Last updated
Aug 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2018

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 85666 CA Primary

Addresses

Primary practice location

360 Tesconi Cir Ste C
Santa Rosa, CA 95401

Mailing address

PO Box 325
Santa Rosa, CA 95402-0325
Phone (510) 459-8137

Other practice location 1

505 San Marin Dr Ste A150
Novato, CA 94945-1357
Phone (510) 459-8137

Other practice location 2

534 B St
Santa Rosa, CA 95401-5211
Phone (707) 579-0465 ext. 307

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

LicenseStateTypeSpecialty
85666CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1427068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535068800000",
    "number": "1568856169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 325",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954020325",
            "telephone_number": "510-459-8137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 TESCONI CIR STE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95401",
            "telephone_number": "510-459-8137"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 San Marin Dr Ste A150",
            "address_purpose": "LOCATION",
            "city": "Novato",
            "state": "CA",
            "postal_code": "949451357",
            "country_code": "US",
            "telephone_number": "510-459-8137",
            "fax_number": "949-798-7874",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "534 B St",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954015211",
            "country_code": "US",
            "telephone_number": "707-579-0465 x307",
            "fax_number": "707-579-0560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAEF",
        "first_name": "M.",
        "middle_name": "PATRICIA",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-23",
        "last_updated": "2018-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.