Individual provider Active NPI

Melissa Fenton

  • Marriage & Family Therapist
  • Roseville, CA
National Provider Identifier
1972116952
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
3400 Douglas Blvd Ste 225
Roseville, CA 95661-4283
Phone
(916) 740-3721
NPI assigned
Aug 28, 2020
Last updated
Oct 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X Primary
Behavior Technician 106S00000X CA

Addresses

Primary practice location

3400 Douglas Blvd Ste 225
Roseville, CA 95661-4283

Mailing address

501 W Broadway Ste 800
San Diego, CA 92101-3546

Other practice location 1

501 W Broadway Ste 800
San Diego, CA 92101-3546
Phone (877) 418-2978

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

Interoperability endpoints

  • Direct secure messaging: telemed2u.melissafenton@160918.advancedmd-direct.com

NPI Registry JSON

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

{
    "created_epoch": "1598572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1972116952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 W BROADWAY STE 800",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921013546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 DOUGLAS BLVD STE 225",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956614283",
            "telephone_number": "916-740-3721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 W Broadway Ste 800",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921013546",
            "country_code": "US",
            "telephone_number": "877-418-2978",
            "fax_number": "866-500-2186",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENTON",
        "first_name": "MELISSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-28",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.