Individual provider Active NPI

Suze Cribbs, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1629448485
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
79298 Issued in CA
Practice address
884 3Rd St
Suite D
Santa Rosa, CA 95404-4533
Phone
(707) 510-1051
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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 79298 CA Primary

Addresses

Primary practice location

884 3Rd St
Suite D
Santa Rosa, CA 95404-4533

Mailing address

PO Box 882
Santa Rosa, CA 95402-0882
Phone (707) 480-3006

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
79298CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Missing Elements CurrentSince Apr 9, 2024 Accepting new patients

Locations

1717 Yulupa Ave
Ste 5
Santa Rosa, CA 95405
Phone (707) 560-1051

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1629448485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 882",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954020882",
            "telephone_number": "707-480-3006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "884 3RD ST",
            "address_2": "SUITE D",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044533",
            "telephone_number": "707-510-1051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIBBS",
        "first_name": "SUZE",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "79298",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.