MRS. JAIN FAIRFAX LANGSTON (NPI# 1649368150) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649368150 |
| Entity Type | Individual |
| Full Name | MRS. JAIN FAIRFAX LANGSTON |
| Other Name | DR. JAIN FAIRFAX |
| Credential | LMFT |
| Practice Address |
2455 Bennett Valley Rd Suite B-208 Santa Rosa CA 95404-5663 |
| Practice Telephone | 7075262580 |
| Practice Fax Number | 7075262580 |
| Mailing Telephone | 7075262580 |
| Mailing Fax Number | 7075262580 |
| Enumeration Date | 2006-10-10 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC 25636 | CA | Behavioral Health & Social Service Providers |
| Street Address |
2455 BENNETT VALLEY RD SUITE B-208 |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95404-5663 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639169576 | Carol Weser | Psychologist | 2455 Bennett Valley Rd, Suite B-208, Santa Rosa, CA 95404-5663 | 2005-10-23 |
| 1831566546 | Andrew E Pearson | Psychologist | 2455 Bennett Valley Rd, Ste B208, Santa Rosa, CA 95404-5667 | 2015-08-28 |
| 1568806560 | Joseph Christopher Puentes | Psychologist | 2455 Bennett Valley Rd, Waterfall Towers Suite B-208, Santa Rosa, CA 95404-5663 | 2013-04-20 |
| 1477887024 | Kofi E Inkabi | Anesthesiology | 2455 Bennett Valley Rd, Suite C-219, Santa Rosa, CA 95404-5663 | 2009-09-30 |
| 1215260591 | Jeremy Blank | Clinical Neuropsychologist | 2455 Bennett Valley Rd, Ste B208, Santa Rosa, CA 95404-5667 | 2009-09-17 |
| 1316160906 | Gary A Blank | Psychologist | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-04-11 |
| 1215087697 | Traviss Family Counseling | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-10 |
| 1881744266 | Sandra S Traviss | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-10 |
| 1073660973 | Patrick A Traviss | Social Worker | 2455 Bennett Valley Rd, Suite 208b, Santa Rosa, CA 95404-5663 | 2007-01-04 |
| 1386674059 | Robert Benavides Jr. | Psychologist | 2455 Bennett Valley Rd, #210 C, Santa Rosa, CA 95404-5663 | 2006-07-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205442217 | David Lee Dutton | Counselor | 201 S. E Street, Santa Rosa, CA 95404 | 2020-09-16 |
| 1114492162 | Jesse Earl Rathbun Jr. | Ophthalmology | 1920 Grace Dr., Santa Rosa, CA 95404 | 2018-10-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1366940504 | New Leaf Counseling and Psychotherapy | Marriage & Family Therapist | 1030 2n Street, Suite B, Santa Rosa, CA 95404 | 2018-01-23 |
| 1659884864 | Jessica Vargas Lopez | Counselor | 3333 Chanate Road, Santa Rosa, CA 95404 | 2017-11-09 |
| 1982135992 | Gaea Keridwyn Coon | Marriage & Family Therapist | 884 Third Street, Suite D, Santa Rosa, CA 95404 | 2017-03-22 |
| 1376084699 | Empire Traditional Chinese Medicine | Acupuncturist | 1030 Second St, Santa Rosa, CA 95404 | 2017-03-20 |
| 1356888705 | Webster Surgery Center, Lp | Clinic/Center | 730 Bennett Valley Road, Santa Rosa, CA 95404 | 2017-01-24 |
| 1205295979 | Sandra Lee Krikorian | Social Worker | 101 E Street, Suite 312, Santa Rosa, CA 95404 | 2016-02-23 |
| 1396134615 | The Center for Body Oriented Psychotherapy & Wellness | Psychologist | 1626 Fourth Street, Santa Rosa, CA 95404 | 2015-01-12 |
| Find all providers in zip 95404 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386269918 | Debra Gold | Marriage & Family Therapist | 835 Piner Rd, Santa Rosa, CA 95403-2063 | 2020-06-09 |
| 1619590700 | Cameron Craig Lutchansky | Marriage & Family Therapist | 2235 Mercury Way Ste 240, Santa Rosa, CA 95407-5443 | 2020-05-22 |
| 1689294498 | Pamela Jo Peringer | Marriage & Family Therapist | 2345 Morningside Cir, Santa Rosa, CA 95405-9132 | 2020-04-22 |
| 1467004028 | Megan Barajas | Marriage & Family Therapist | 3440 Mendocino Ave, Santa Rosa, CA 95403-2221 | 2019-07-14 |
| 1275193674 | Marie Romano | Marriage & Family Therapist | 3434 Mendocino Ave Bldg C, Santa Rosa, CA 95403-2274 | 2019-06-18 |
| 1851956932 | Amy Theodore | Marriage & Family Therapist | 2455 Bennett Valley Rd Ste B201, Santa Rosa, CA 95404-5667 | 2019-05-05 |
| 1609335314 | Heidi Diebel | Marriage & Family Therapist | 9291 Oak Trail Cir, Santa Rosa, CA 95409 | 2019-03-13 |
| 1114413952 | Jordan Morrison | Marriage & Family Therapist | 1260 N Dutton Ave Ste 230, Santa Rosa, CA 95401-7161 | 2018-07-05 |
| 1568958437 | Bianca Avina | Marriage & Family Therapist | 95 Montgomery Dr. #112, Santa Rosa, CA 95404 | 2018-07-03 |
| 1174012710 | Humanidad Therapy and Education Services | Marriage & Family Therapist | 95 Montgomery Dr Ste 112, Santa Rosa, CA 95404-6617 | 2018-05-09 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95404 |
Please comment or provide details below to improve the information on MRS. JAIN FAIRFAX LANGSTON.
| 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.