Individual provider Active NPI

Grace Marie Sakurada, MS, LMFT

  • Marriage & Family Therapist
  • Willits, CA
National Provider Identifier
1780128793
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFTI 96796 Issued in CA
Practice address
104 W Mendocino Ave
Willits, CA 95490-3412
Phone
(916) 879-3054
NPI assigned
Dec 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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 MFTI 96796 CA Primary

Addresses

Primary practice location

104 W Mendocino Ave
Willits, CA 95490-3412

Mailing address

333 Creekside Dr
Willits, CA 95490-3611
Phone (916) 879-3054

Other practice location 1

333 Creekside Dr
Willits, CA 95490-3611
Phone (916) 879-3054

Other practice location 2

169 Mason St Ste 300
Ukiah, CA 95482-4483
Phone (707) 463-3300

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
I20240417003713 CA Practitioner - Marriage and Family Therapist 2961841325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Long Valley Health CenterGroup PAC ID 8628965852, 11 clinicians

Practice addresses (Care Compare)

PO Box
Suite 870
Laytonville, CA 95454

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MFTI 96796CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Long Valley Health Center CurrentSince Mar 15, 2024 Accepting new patients

Locations

50 Branscomb Rd
Laytonville, CA 95454
Phone (707) 984-6131

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AECBBA

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": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1780128793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 CREEKSIDE DR",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903611",
            "telephone_number": "916-879-3054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W MENDOCINO AVE",
            "city": "WILLITS",
            "state": "CA",
            "postal_code": "954903412",
            "telephone_number": "916-879-3054"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 Creekside Dr",
            "address_purpose": "LOCATION",
            "city": "Willits",
            "state": "CA",
            "postal_code": "954903611",
            "country_code": "US",
            "telephone_number": "916-879-3054",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Mason St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Ukiah",
            "state": "CA",
            "postal_code": "954824483",
            "country_code": "US",
            "telephone_number": "707-463-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SAKURADA",
        "first_name": "GRACE",
        "middle_name": "MARIE",
        "credential": "MS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-09",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFTI 96796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willits, CA

Sources for this page

Verify at the official NPI Registry.