Active NPI
Stacey Soares, MA, MFT
- Marriage & Family Therapist
- Sonora, CA
National Provider Identifier
1902082167
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 41684
- Practice address
- South 101 Forest Ave
Sonora, CA 95370 - Phone
- (209) 588-8993
- NPI assigned
- Jan 17, 2008
- Last updated
- Jan 17, 2008
- 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 | MFT 41684 | CA | Primary |
Addresses
Primary practice location
South 101 Forest Ave
Sonora, CA 95370
Mailing address
PO Box 1148
Soulsbyville, CA 95372-1148
Phone (209) 588-8993
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 41684 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1200528000000",
"number": "1902082167",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1148",
"city": "SOULSBYVILLE",
"state": "CA",
"postal_code": "953721148",
"telephone_number": "209-588-8993"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "SOUTH 101 FOREST AVE",
"city": "SONORA",
"state": "CA",
"postal_code": "95370",
"telephone_number": "209-588-8993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOARES",
"first_name": "STACEY",
"credential": "MA, MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-17",
"last_updated": "2008-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 41684",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sonora, CA
- Robert Christopher Smith Jr.
- Samantha C Smith
- Steven A Smith, M.D.
- Christine Elaine Snedeger
- Barbara A Snyder, PA, C/NP
- Anne Lynn Sobczak, ASW
- Solo Internal Medicine
- Sonora Anesthesia Services a Medical Group Inc
- Sonora Community Hospital (Forest Road Health & Wellness Center)
- Sonora Community Hospital (Sierra Cardiology Department)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.