Individual provider Active NPI

Maryjo Brooks Motl, LMFT

  • Marriage & Family Therapist
  • West Sacramento, CA
National Provider Identifier
1649737016
Registry record updated Feb 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
40879 Issued in CA
Practice address
2101 Stone Blvd Ste 175
West Sacramento, CA 95691-4055
Phone
(916) 425-7733
Fax
(916) 372-2466
NPI assigned
Feb 21, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2019

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 40879 CA Primary

Addresses

Primary practice location

2101 Stone Blvd Ste 175
West Sacramento, CA 95691-4055

Mailing address

2101 Stone Blvd Ste 175
West Sacramento, CA 95691-4055
Phone (916) 425-7733

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
40879CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1550707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550707200000",
    "number": "1649737016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 STONE BLVD STE 175",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956914055",
            "telephone_number": "916-425-7733",
            "fax_number": "916-372-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 STONE BLVD STE 175",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956914055",
            "telephone_number": "916-425-7733",
            "fax_number": "916-372-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS MOTL",
        "first_name": "MARYJO",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-21",
        "last_updated": "2019-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.