Individual provider Active NPI

Rita Herron

  • Marriage & Family Therapist
  • Stockton, CA
National Provider Identifier
1659629285
Registry record updated Oct 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117262 Issued in CA
Practice address
620 N Aurora St Ste 4
Stockton, CA 95202-2276
Phone
(209) 468-9631
NPI assigned
Aug 29, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2023

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 117262 CA Primary

Addresses

Primary practice location

620 N Aurora St Ste 4
Stockton, CA 95202-2276

Mailing address

620 N Aurora St Ste 4
Stockton, CA 95202-2276
Phone (209) 953-7012

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
117262CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
San Joaquin Behavioral Health Services Mental Health Current Accepting new patients
San Joaquin County Behavioral Health Services PastSince Oct 15, 2023 Accepting new patients
San Joaquin County Behavioral Health Services PastSince Oct 15, 2023 Accepting new patients

Locations

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

620 N Aurora St
Ste 4
Stockton, CA 95202
Phone (209) 468-9631

Organizations & group practices 3

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": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1659629285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N AURORA ST STE 4",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022276",
            "telephone_number": "209-953-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N AURORA ST STE 4",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952022276",
            "telephone_number": "209-468-9631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRON",
        "first_name": "RITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

Verify at the official NPI Registry.