Erika Lynn Malsom, MFT-INTERN

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

MFC41677 Issued in CA

Practice address

137 E Oak Street
Fort Bragg, CA 95437

Phone

(707) 961-0172

Fax

(844) 388-6167

NPI assigned

May 13, 2014

Last updated

Jun 5, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Mendocino Coast Hospitality Center

  dba Hospitality Clinic

  • Community/Behavioral Health Agency
  • Fort Bragg, CA
  • NPI 1831522333
  NPD (past)
• Mendocino Coast Hospitality Center

  • Community/Behavioral Health Agency
  • Fort Bragg, CA
  • NPI 1902357437
  NPD (past)

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559692800000",
    "number": "1801207899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2168",
            "address_2": "MENDOCINO COAST HOSPITALITY CENTER",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-0172",
            "fax_number": "844-388-6167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 E OAK STREET",
            "city": "FORT BRAGG",
            "state": "CA",
            "postal_code": "95437",
            "telephone_number": "707-961-0172",
            "fax_number": "844-388-6167"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "32670 Highway 20 # 2",
            "address_purpose": "LOCATION",
            "city": "Fort Bragg",
            "state": "CA",
            "postal_code": "954375708",
            "country_code": "US",
            "telephone_number": "707-467-2010",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALSOM",
        "first_name": "ERIKA",
        "middle_name": "LYNN",
        "credential": "MFT-INTERN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2019-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": "CA",
            "license": "92589",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "MFC41677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Grant Lukomsky, PA-C
• Lynette Kline O.D.
• Suzanna Macias, RD
• William Matthew Mahon, M.D.
• Michele Maley
• Mark David Levine MD, Fort Bragg Professional Corporation
• Joseph E Martin, PA
• Lucila Martinez
• Linnea Marie Matthews, FNP
• James Frederick Mattson, DDS

• Community/Behavioral Health Agency in Fort Bragg, CA
• Providers in Fort Bragg, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2019; 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.