Active NPI
Jamie Anderson
- Marriage & Family Therapist
- Walnut Creek, CA
National Provider Identifier
1790163111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 96375
- Practice address
- 2920 Camino Diablo
#200
Walnut Creek, CA 94597-3985 - Phone
- (925) 268-8205
- NPI assigned
- May 18, 2015
- Last updated
- Nov 28, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 96375 | CA | Primary |
Addresses
Primary practice location
2920 Camino Diablo
#200
Walnut Creek, CA 94597-3985
Mailing address
2063 Ascot Dr
Unit 216
Moraga, CA 94556-2264
Phone (925) 377-0696
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Feb 14, 2024 through Feb 14, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 96375 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1431907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480291200000",
"number": "1790163111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2063 ASCOT DR",
"address_2": "UNIT 216",
"city": "MORAGA",
"state": "CA",
"postal_code": "945562264",
"telephone_number": "925-377-0696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2920 CAMINO DIABLO",
"address_2": "#200",
"city": "WALNUT CREEK",
"state": "CA",
"postal_code": "945973985",
"telephone_number": "925-268-8205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "JAMIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-05-18",
"last_updated": "2016-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "96375",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walnut Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.