Active NPI
Paula Suzanne Dwelly, PH.D, MFCC
- Marriage & Family Therapist
- Colfax, CA
National Provider Identifier
1669588091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MM015238
- Practice address
- 21520 Canyon Way
Colfax, CA 95713 - Phone
- (530) 637-4116
- NPI assigned
- Aug 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MM015238 | CA | Primary |
Addresses
Primary practice location
21520 Canyon Way
Colfax, CA 95713
Mailing address
PO Box 1047
Weimar, CA 95736-1047
Phone (530) 637-4116
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MM015238 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1669588091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1047",
"city": "WEIMAR",
"state": "CA",
"postal_code": "957361047",
"telephone_number": "530-637-4116",
"fax_number": "530-637-4116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21520 CANYON WAY",
"city": "COLFAX",
"state": "CA",
"postal_code": "95713",
"telephone_number": "530-637-4116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWELLY",
"first_name": "PAULA",
"middle_name": "SUZANNE",
"name_prefix": "Dr.",
"credential": "PH.D, MFCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-21",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MM015238",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colfax, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.