Individual provider Active NPI

Rachel Marie Needham

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1609311018
Registry record updated Jun 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
1624 Santa Clara Dr Ste 145
Roseville, CA 95661-3500
Phone
(916) 779-2455
NPI assigned
Dec 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X
Marriage & Family Therapist 106H00000X Primary

Addresses

Primary practice location

1624 Santa Clara Dr Ste 145
Roseville, CA 95661-3500

Mailing address

1624 Santa Clara Dr Ste 145
Roseville, CA 95661-3500
Phone (916) 779-2455

Other practice location 1

232 E Gish Rd
San Jose, CA 95112-4706
Phone (408) 453-7616

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
106718CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pacific Clinics PastSince Jul 10, 2022 Accepting new patients

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560816000000",
    "number": "1609311018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 SANTA CLARA DR STE 145",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613500",
            "telephone_number": "916-779-2455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 SANTA CLARA DR STE 145",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956613500",
            "telephone_number": "916-779-2455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 E Gish Rd",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951124706",
            "country_code": "US",
            "telephone_number": "408-453-7616",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NEEDHAM",
        "first_name": "RACHEL",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2019-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.