Individual provider Active NPI

Mindy Lynne Frisch, MFT INTERN

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1881065761
Registry record updated Oct 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
89759 Issued in CA
Practice address
3650 Standish Ave
Santa Rosa, CA 95407-8113
Phone
(707) 585-6108
NPI assigned
Oct 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2015

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 89759 CA Primary

Addresses

Primary practice location

3650 Standish Ave
Santa Rosa, CA 95407-8113

Mailing address

1742 Silverado Cir
Petaluma, CA 94954-5707
Phone (707) 762-5428

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
89759CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1445040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445040000000",
    "number": "1881065761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1742 SILVERADO CIR",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949545707",
            "telephone_number": "707-762-5428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 STANDISH AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954078113",
            "telephone_number": "707-585-6108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRISCH",
        "first_name": "MINDY",
        "middle_name": "LYNNE",
        "credential": "MFT INTERN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-17",
        "last_updated": "2015-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "89759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2015; 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.