Individual provider Active NPI

James Russel Luper, MA, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1770790826
Registry record updated Mar 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC42057 Issued in CA
Practice address
200 Montgomery Dr
Suite C
Santa Rosa, CA 95404-6633
Phone
(707) 529-1247
Fax
(707) 528-6238
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2015

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 MFC42057 CA Primary

Addresses

Primary practice location

200 Montgomery Dr
Suite C
Santa Rosa, CA 95404-6633

Mailing address

2665 Santa Rosa Ave # 175
Santa Rosa, CA 95407-7683
Phone (707) 529-1247

Other identifiers 1

IdentifierTypeStateIssuer
MFC42057OtherCAMARRIAGE& FAMILYTHERAPIST

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
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC42057CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427414400000",
    "number": "1770790826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2665 SANTA ROSA AVE # 175",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954077683",
            "telephone_number": "707-529-1247",
            "fax_number": "707-528-6238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MONTGOMERY DR",
            "address_2": "SUITE C",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954046633",
            "telephone_number": "707-529-1247",
            "fax_number": "707-528-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPER",
        "first_name": "JAMES",
        "middle_name": "RUSSEL",
        "name_prefix": "Mr.",
        "credential": "MA, MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-17",
        "last_updated": "2015-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC42057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARRIAGE& FAMILYTHERAPIST",
            "identifier": "MFC42057",
            "state": "CA"
        }
    ],
    "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 Mar 27, 2015; 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.