Active NPI
Nicholas McRae Mallonee, BA PSYCHOLOGY
- Counselor
- Santa Rosa, CA
National Provider Identifier
1679899587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 3440 Airway Dr
Suite E
Santa Rosa, CA 95403-2065 - Phone
- (707) 544-3299
- Fax
- (707) 544-6837
- NPI assigned
- Apr 16, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
3440 Airway Dr
Suite E
Santa Rosa, CA 95403-2065
Mailing address
3440 Airway Dr
Suite E
Santa Rosa, CA 95403-2065
Phone (707) 544-3299
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
- Bachelor of Arts
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271376000000",
"number": "1679899587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3440 AIRWAY DR",
"address_2": "SUITE E",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032065",
"telephone_number": "707-544-3299",
"fax_number": "707-544-6837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3440 AIRWAY DR",
"address_2": "SUITE E",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954032065",
"telephone_number": "707-544-3299",
"fax_number": "707-544-6837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MALLONEE",
"first_name": "NICHOLAS",
"middle_name": "MCRAE",
"name_prefix": "Mr.",
"credential": "BA PSYCHOLOGY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-16",
"last_updated": "2010-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.