Active NPI
Deborah McCallum, MFT
- Marriage & Family Therapist
- Sebastopol, CA
National Provider Identifier
1902260938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 85041
- Practice address
- 470 Pitt Ave
Sebastopol, CA 95472-3747 - Phone
- (707) 861-8648
- NPI assigned
- Apr 6, 2016
- 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 | 85041 | CA | Primary |
Addresses
Primary practice location
470 Pitt Ave
Sebastopol, CA 95472-3747
Mailing address
PO Box 25
Sebastopol, CA 95473-0025
Phone (707) 861-8648
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 85041 | Other | CA | BOARD OF BEHAVIORAL SCIENCES |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 85041 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1459900800000",
"number": "1902260938",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954730025",
"telephone_number": "707-861-8648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 PITT AVE",
"city": "SEBASTOPOL",
"state": "CA",
"postal_code": "954723747",
"telephone_number": "707-861-8648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCCALLUM",
"first_name": "DEBORAH",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-06",
"last_updated": "2016-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "85041",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCES",
"identifier": "85041",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}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 Apr 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.