Carol Elizabeth Fabric, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

M13884 Issued in CA

Practice address

21 Encina Place
San Anselmo, CA 94960

Phone

(415) 721-7864

NPI assigned

Jan 23, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Carol Elizabeth Rucker Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720133648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 ENCINA PLACE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "94960",
            "telephone_number": "415-721-7864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ENCINA PLACE",
            "city": "SAN ANSELMO",
            "state": "CA",
            "postal_code": "94960",
            "telephone_number": "415-721-7864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABRIC",
        "first_name": "CAROL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "M13884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "RUCKER",
            "middle_name": "ELIZABETH",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Susan Edelstein, PHD
• Lucrecia Gloria Espejo, DDS
• Kristy Lauren Ewert, PT
• Susan Ezra, RN
• Bruce Arlen Fabric, MD
• Liza Fartash, D.D.S.
• Grant Finn
• Grace Fisher, MFT
• Natalie Forsythe, AMFT
• Angela M Franco Gomez

• Marriage & Family Therapist in San Anselmo, CA
• Providers in San Anselmo, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.