Individual provider Active NPI

Jeanne Marie Ivary, MFTI

  • Marriage & Family Therapist
  • Sacramento, CA
National Provider Identifier
1649530411
Registry record updated Jan 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
IMF71777 Issued in CA
Practice address
9343 Tech Center Dr
Sacramento, CA 95826-2563
Phone
(916) 388-6400
NPI assigned
May 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IMF 71777 CA
Social Worker 104100000X
Marriage & Family Therapist 106H00000X IMF71777 CA Primary

Addresses

Primary practice location

9343 Tech Center Dr
Sacramento, CA 95826-2563

Mailing address

9343 Tech Center Dr
Sacramento, CA 95826-2563
Phone (916) 388-6400

Other identifiers 1

IdentifierTypeStateIssuer
71777OtherCABOARD OF BEHAVIORAL SCIENCES MFTI REG

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq Health Information Exchange (HIE) The Permanente Medical Group

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240116003452 CA Practitioner - Marriage and Family Therapist 9335591221 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
IMF 71777CAMDMental Health Counselor
109217CAMDClinical Social Worker
IMF71777CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emq Families First Past Accepting new patients

Organizations & group practices 2

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": "1337904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1649530411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9343 TECH CENTER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262563",
            "telephone_number": "916-388-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9343 TECH CENTER DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958262563",
            "telephone_number": "916-388-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVARY",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "MFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-25",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF 71777",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF71777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES MFTI REG",
            "identifier": "71777",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7300 Wyndham Dr",
            "city": "Sacramento",
            "state": "CA",
            "country_code": "US",
            "postal_code": "958234913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

Verify at the official NPI Registry.