Individual provider Active NPI

Gregory Thomas Kirnos Boccieri, LMFT152145

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1699559187
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152145 Issued in CA
Practice address
406 Chinn St
Santa Rosa, CA 95404-4339
Phone
(510) 359-7319
NPI assigned
Aug 24, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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 152145 CA Primary

Addresses

Primary practice location

406 Chinn St
Santa Rosa, CA 95404-4339

Mailing address

406 Chinn St
Santa Rosa, CA 95404-4339
Phone (510) 359-7319

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
152145CAMDAnesthesiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1692835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1699559187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 CHINN ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044339",
            "telephone_number": "510-359-7319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 CHINN ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954044339",
            "telephone_number": "510-359-7319"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRNOS BOCCIERI",
        "first_name": "GREGORY",
        "middle_name": "THOMAS",
        "credential": "LMFT152145",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-08-24",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152145",
            "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 Jan 7, 2025; 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.