Individual provider Active NPI

Jeffrey Dean Palmer, MFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1922169598
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC32355 Issued in CA
Practice address
1330 N Dutton Ave Ste 100
Santa Rosa, CA 95401-4646
Phone
(707) 526-8306
NPI assigned
Dec 13, 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 MFC32355 CA Primary

Addresses

Primary practice location

1330 N Dutton Ave Ste 100
Santa Rosa, CA 95401-4646

Mailing address

PO Box 14142
Santa Rosa, CA 95402-6142
Phone (707) 545-5195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240424003735 CA Practitioner - Marriage and Family Therapist 9537463963 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Psych Strategies Inc a Psychological CorpGroup PAC ID 0446144497, 23 clinicians

Practice addresses (Care Compare)

1160 N Dutton Ave
Suite 230
Santa Rosa, CA 95401-4658
Phone (707) 303-3201

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC32355CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psych Strategies Inc a Psychological Corp CurrentSince Feb 13, 2024 Accepting new patients

Locations

1160 N Dutton Ave
Ste 230
Santa Rosa, CA 95401
Phone (707) 303-3201

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922169598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14142",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954026142",
            "telephone_number": "707-545-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1330 N DUTTON AVE STE 100",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014646",
            "telephone_number": "707-526-8306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JEFFREY",
        "middle_name": "DEAN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32355",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.