Jedidiah Purses, AMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

111405 Issued in CA

Practice address

300 Tamal PLZ Ste 220
Corte Madera, CA 94925-1136

Phone

(415) 459-5206

NPI assigned

Dec 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577664000000",
    "number": "1609415207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 TAMAL PLZ STE 220",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251136",
            "telephone_number": "415-459-5206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 TAMAL PLZ STE 220",
            "city": "CORTE MADERA",
            "state": "CA",
            "postal_code": "949251136",
            "telephone_number": "415-459-5206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSES",
        "first_name": "JEDIDIAH",
        "name_prefix": "Mr.",
        "credential": "AMFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-12-30",
        "last_updated": "2019-12-30",
        "certification_date": "2019-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "111405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gordana Potrebic, PSY.D.
• Michael Eric Prentice, CCC-SLP
• Deon Pretorius, RPH
• Kelly D Prothero, LCSW
• Psychserv Medical Corporation
• Susan Theresa Quigley, MFT
• Josephine Rabb, MFT
• Hillary Green Redlin, MD
• Justine Francesca Reese, AMFT
• Deborah A Resnikoff

• Mental Health Counselor in Corte Madera, CA
• Providers in Corte Madera, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.