Zeruah Reedom

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

106913 Issued in CA

Practice address

1400 W Minthorn St
Lake Elsinore, CA 92530-2808

Phone

(951) 245-3299

NPI assigned

Jul 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 4, 2024 through Jan 4, 2028

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• County of Riverside

  • Community/Behavioral Health Agency
  • Lake Elsinore, CA
  • NPI 1346860210
  NPD

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

{
    "created_epoch": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591747200000",
    "number": "1588006357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 W MINTHORN ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302808",
            "telephone_number": "951-245-3299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 W MINTHORN ST",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302808",
            "telephone_number": "951-245-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19510 Van Buren Blvd # F3-1029",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925089457",
            "country_code": "US",
            "telephone_number": "909-213-0729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REEDOM",
        "first_name": "ZERUAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2020-06-10",
        "certification_date": "2020-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1588006357",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry Raskey, D.C.
• Patrick Rath
• Sheri Malinda Raymo
• Phillip Rechister
• James Reed
• Janepher Remigio
• Tara C Renzetti
• Restore Health Medical Management
• Restored Minds Inc
• Revolution Medical Supply, LLC

• Marriage & Family Therapist in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2020; 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.

Verify at the official NPI Registry.