Active NPI
Jessie Rose Shepherd, MFTI
- Marriage & Family Therapist
- Sebastopol, CA
National Provider Identifier
1891965000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 7680 Elphick Rd
Sebastopol, CA 95472-4751 - Phone
- (707) 543-6478
- NPI assigned
- Mar 4, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | Primary |
Addresses
Primary practice location
7680 Elphick Rd
Sebastopol, CA 95472-4751
Mailing address
1266 14TH St.
Oakland, CA 94609
Phone (510) 867-0963
Other names 1
- Jessie Rose Greene
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1204588800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1891965000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1266 14TH ST.",
"city": "OAKLAND",
"state": "CA",
"postal_code": "94609",
"telephone_number": "510-867-0963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7680 ELPHICK RD",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954724751",
"telephone_number": "707-543-6478"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHEPHERD",
"first_name": "JESSIE",
"middle_name": "ROSE",
"credential": "MFTI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-03-04",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JESSIE",
"last_name": "GREENE",
"middle_name": "ROSE",
"credential": "MFTI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Sebastopol, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.