Active NPI
Sunum Khatiba Jamall, LMFT
- Marriage & Family Therapist
- Sacramento, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 146780
- Practice address
- 100 Howe Ave Ste 170N
Sacramento, CA 95825-8241 - Phone
- (925) 282-1778
- Fax
- (415) 296-5299
- NPI assigned
- Jun 14, 2017
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Marriage & Family Therapist | 106H00000X | 146780 | CA | Primary |
Addresses
Primary practice location
100 Howe Ave Ste 170N
Sacramento, CA 95825-8241
Mailing address
100 Howe Ave Ste 170N
Sacramento, CA 95825-8241
Phone (925) 282-1778
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 106S00000X | Other | BEHAVIOR TECHNICIAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 146780 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Coast Psychiatric Associates Inc | Current | Accepting new patients |
Locations
1480 64th St
Ste 150
Emeryville, CA 94608
Phone (415) 296-5292
2365 Iron Point Rd
Ste 210
Folsom, CA 95630
Phone (925) 360-5264
100 Howe Ave
Ste 170N
Sacramento, CA 95825
Phone (415) 296-5100
490 Post St
Ste 1043
San Francisco, CA 94102
Phone (415) 409-0944
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497398400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719532800000",
"number": "1609306331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 HOWE AVE STE 170N",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958258241",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 HOWE AVE STE 170N",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958258241",
"telephone_number": "925-282-1778",
"fax_number": "415-296-5299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JAMALL",
"first_name": "SUNUM",
"middle_name": "KHATIBA",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-06-14",
"last_updated": "2024-06-28",
"certification_date": "2024-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "146780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BEHAVIOR TECHNICIAN",
"identifier": "106S00000X",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.