Individual provider Active NPI

Jo Ellen Ihinger

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1962564500
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
42286 Issued in CA
Practice address
3333 Chanate Rd
Santa Rosa, CA 95404-1707
Phone
(707) 565-7836
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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 42286 CA Primary

Addresses

Primary practice location

3333 Chanate Rd
Santa Rosa, CA 95404-1707

Mailing address

3333 Chanate Rd
Santa Rosa, CA 95404-1707

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
I20241108003805 CA Practitioner - Marriage and Family Therapist 0840724175 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of SonomaGroup PAC ID 4688658651, 28 clinicians

Practice addresses (Care Compare)

2225 Challenger Way
Santa Rosa, CA 95407-5441
Phone (707) 565-4861

2350 Professional Dr
Santa Rosa, CA 95403-3018
Phone (707) 565-4861

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
42286CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Sonoma CurrentSince Oct 30, 2024 Accepting new patients
County of Sonoma Current Accepting new patients
County of Sonoma CurrentSince Oct 30, 2024 Accepting new patients

Locations

1450 Neotomas Ave
Ste 200
Santa Rosa, CA 95405
Phone (707) 565-4131

2225 Challenger Way
Santa Rosa, CA 95407
Phone (707) 565-4101

3333 Chanate Rd
Santa Rosa, CA 95404
Phone (707) 565-4900

Organizations & group practices 3

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": "1405382400000",
    "number": "1962564500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 CHANATE RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954041707",
            "telephone_number": "707-565-7836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IHINGER",
        "first_name": "JO",
        "middle_name": "ELLEN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "42286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.