Individual provider Active NPI

Robert B Casanova, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1831115864
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 37137 Issued in CA
Practice address
319 S E St Ste a
Santa Rosa, CA 95404-5132
Phone
(707) 544-7000
Fax
(707) 544-7006
NPI assigned
Jul 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC 37137 CA Primary

Addresses

Primary practice location

319 S E St Ste a
Santa Rosa, CA 95404-5132

Mailing address

319 S E St Ste a
Santa Rosa, CA 95404-5132
Phone (707) 544-7000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 37137CAMDMarriage & Family Therapist
37137CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831115864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 S E ST STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045132",
            "telephone_number": "707-544-7000",
            "fax_number": "707-544-7006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 S E ST STE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045132",
            "telephone_number": "707-544-7000",
            "fax_number": "707-544-7006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASANOVA",
        "first_name": "ROBERT",
        "middle_name": "B",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 37137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.