MR. CARL FREDERICK JEFFERSON (NPI# 1063546083) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063546083 |
| Entity Type | Individual |
| Full Name | MR. CARL FREDERICK JEFFERSON |
| Credential | C.A.S. |
| Practice Address |
145 Bost Ave Nevada City CA 95959-3249 |
| Mailing Address |
13419 Mckitrick Ranch Rd Nevada City CA 95959-9740 |
| Practice Telephone | 5302659045 |
| Practice Fax Number | 5304787977 |
| Mailing Telephone | 5302778809 |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2016-08-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | C.A.S. | 1824 | 01 |
| Street Address |
145 BOST AVE |
| City | NEVADA CITY |
| State | CA |
| Zip Code | 95959-3249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801493341 | Thomas J Burnett | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2020-10-07 |
| 1740822154 | Sandra N Marra | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2019-10-17 |
| 1750922456 | Alix M Andersen | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2019-10-03 |
| 1750863676 | Amy Cunag | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2018-09-06 |
| 1548775125 | James E Johnson | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2017-12-05 |
| 1235644071 | Granite Wellness Centers | Substance Abuse Rehabilitation Facility | 145 Bost Ave, Nevada City, CA 95959-3249 | 2017-12-01 |
| 1578005393 | Jeffery Allan Johnson | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2016-11-10 |
| 1477949105 | Loran Gillaspy | Substance Abuse Rehabilitation Facility | 145 Bost Ave, Nevada City, CA 95959-3249 | 2015-04-09 |
| 1558781104 | William Miner Maguire Jr. | Specialist | 145 Bost Ave, Nevada City, CA 95959-3249 | 2014-04-22 |
| 1164749222 | Robert Stephen Ullom | Counselor | 145 Bost Ave, Nevada City, CA 95959-3249 | 2010-04-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225639495 | Bringing Medicine Culturally Competent Counseling and Indigenous | Marriage & Family Therapist | 206 Sacramento St Suite 212, Nevada, CA 95959 | 2020-11-04 |
| 1699376210 | Michele Tsihlas | Health Educator | 18411 Tyler Foote Road, Nevada City, CA 95959 | 2020-11-02 |
| 1649835380 | Jared Shawn Dubose | Counselor | 24077 Ca 49, Nevada City, CA 95959 | 2019-05-08 |
| 1447755590 | Maria Scarano | Chiropractor | 513 Searls Ave, Unit 8, Nevada City, CA 95959 | 2018-03-29 |
| 1922559020 | Megan Allen | Counselor | 985 Helling Way, Nevada City, CA 95959 | 2016-10-24 |
| 1417331885 | Karla Diane Moore Pinola | Counselor | 150 Bost Avenue, Nevada City, CA 95959 | 2015-07-16 |
| 1700212263 | Victoria Moran | Marriage & Family Therapist | 206 Sacramento St Ste 203, Nevada City, CA 95959 | 2013-09-16 |
| 1528308905 | Justin Burkett | Acupuncturist | 101 Providence Mine Rd Ste 105b, Nevada City, CA 95959 | 2013-02-22 |
| 1114276623 | Michelle Dion Young | Case Manager/Care Coordinator | 138 New Mohawk #200, Nevad City, CA 95959 | 2012-08-30 |
| 1750668497 | Rachael Courtier | Social Worker | Sierra Family Medical Clinic, 15301 Tyler Foote Road, Nevada City, CA 95959 | 2011-11-09 |
| Find all providers in zip 95959 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649835380 | Jared Shawn Dubose | Counselor | 24077 Ca 49, Nevada City, CA 95959 | 2019-05-08 |
| 1437616372 | Jamie Jean Lyons | Counselor | 10591 Milhous Dr, Nevada City, CA 95959-8501 | 2019-02-27 |
| 1093224537 | Jessica Robyn Garren | Counselor | 15561 Cascade Loop, Nevada City, CA 95959-8841 | 2017-09-27 |
| 1790220671 | Lynlee Ann Lyckberg | Counselor | 232 Brock Rd, Nevada City, CA 95959-2902 | 2016-12-30 |
| 1922559020 | Megan Allen | Counselor | 985 Helling Way, Nevada City, CA 95959 | 2016-10-24 |
| 1194128827 | Sharon Dawn Krusi | Counselor | 12586 Summit Ridge Dr, Nevada City, CA 95959-9534 | 2014-10-08 |
| 1285075879 | Linda Parenzan Grotke | Counselor | 16689 Rock Creek Rd, Nevada City, CA 95959-8635 | 2013-07-10 |
| 1699012948 | Jennifer Lescher | Counselor | 475 Spring St Apt 1b, Nevada City, CA 95959-2426 | 2013-01-07 |
| 1982956306 | Megan Dittmann | Counselor | 19903 New Rome Rd, Nevada City, CA 95959-9419 | 2012-10-09 |
| 1487893301 | Jane Vendola Lee | Counselor | 401 Spring St Ste 203, Nevada City, CA 95959-2448 | 2009-02-17 |
| Find all providers in NEVADA CITY | ||||
| City | NEVADA CITY |
| Zip Code | 95959 |
Please comment or provide details below to improve the information on MR. CARL FREDERICK JEFFERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.