Individual provider Active NPI

Aimee Fouche

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1770985558
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
121673 Issued in CA
Practice address
2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone
(707) 565-1109
NPI assigned
Sep 23, 2014
Reactivated
Feb 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 121673 CA Primary

Addresses

Primary practice location

2225 Challenger Way
Santa Rosa, CA 95407-5441

Mailing address

2225 Challenger Way
Santa Rosa, CA 95407
Phone (707) 565-1109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240723002651 CA Practitioner - Marriage and Family Therapist 5092251397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of SonomaGroup PAC ID 4688658651, 28 clinicians

Practice addresses (Care Compare)

2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone (707) 565-4861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sonoma Current Accepting new patients
County of Sonoma CurrentSince Jun 1, 2024 Accepting new patients
County of Sonoma CurrentSince Jun 1, 2024 Accepting new patients

Locations

1450 Neotomas Ave
Ste 200
Santa Rosa, CA 95405
Phone (707) 565-4131

2225 Challenger Way
Santa Rosa, CA 95407
Phone (707) 565-4101

Organizations & group practices 3

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": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1770985558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95407",
            "telephone_number": "707-565-1109",
            "fax_number": "707-823-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 CHALLENGER WAY",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954075441",
            "telephone_number": "707-565-1109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOUCHE",
        "first_name": "AIMEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "deactivation_date": "2020-11-17",
        "reactivation_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "121673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.