Individual provider Active NPI

Caroline J Leatherman

  • Student in an Organized Health Care Education/Training Program
  • Roseville, CA
National Provider Identifier
1720925779
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
License
AMFT162132 Issued in CA
Practice address
2260 Douglas Blvd Ste 150
Roseville, CA 95661-4273
Phone
(916) 573-0379
NPI assigned
Apr 29, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training ProgramGroup: 193200000X MULTI-SPECIALTY GROUP 390200000X AMFT162132 CA Primary
Marriage & Family TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 106H00000X AMFT162132 CA

Addresses

Primary practice location

2260 Douglas Blvd Ste 150
Roseville, CA 95661-4273

Mailing address

2260 Douglas Blvd Ste 150
Roseville, CA 95661-4273
Phone (916) 573-0379

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
AMFT162132CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling Center of Marriage and Family Therapy Corp Multi-Specialty Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1777420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1720925779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2260 DOUGLAS BLVD STE 150",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614273",
            "telephone_number": "916-573-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 DOUGLAS BLVD STE 150",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614273",
            "telephone_number": "916-573-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERMAN",
        "first_name": "CAROLINE",
        "middle_name": "J",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-04-29",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "AMFT162132",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT162132",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2026; 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.