Individual provider Active NPI

Dina L Sanders-Mayfield

  • Marriage & Family Therapist
  • Fairfield, CA
National Provider Identifier
1669097457
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
119230 Issued in CA
Practice address
801 Empire St
Fairfield, CA 94533-5702
Phone
(707) 425-5744
Fax
(707) 425-5162
NPI assigned
Jun 8, 2020
Last updated
Mar 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7876 CA
Marriage & Family Therapist 106H00000X 119230 CA Primary

Addresses

Primary practice location

801 Empire St
Fairfield, CA 94533-5702

Mailing address

PO Box 2433
Fairfield, CA 94533-0243
Phone (510) 326-4393

Other practice location 1

1745 Enterprise Dr
Fairfield, CA 94533-5801
Phone (707) 927-4282

Other names 1

  • Dina L Mayfield Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Virtue Health Information Exchange (HIE) Agape Counseling Center and Network

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
119230CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1669097457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2433",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945330243",
            "telephone_number": "510-326-4393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 EMPIRE ST",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945335702",
            "telephone_number": "707-425-5744",
            "fax_number": "707-425-5162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1745 Enterprise Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfield",
            "state": "CA",
            "postal_code": "945335801",
            "country_code": "US",
            "telephone_number": "707-927-4282",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANDERS-MAYFIELD",
        "first_name": "DINA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-08",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "7876",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119230",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Virtue",
            "affiliation": "Y",
            "affiliationName": "Agape Counseling Center and Network",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1745 Enterprise Dr",
            "address_2": "Bldg 2",
            "city": "Fairfield",
            "state": "CA",
            "country_code": "US",
            "postal_code": "945335801",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "DINA",
            "last_name": "MAYFIELD",
            "middle_name": "L",
            "credential": "MAYFIELD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fairfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2021; 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.