Active NPI
Tiffany Wetzel
- Marriage & Family Therapist
- Sacramento, CA
National Provider Identifier
1063523876
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 42954
- Practice address
- 2830 I St
Suite 105
Sacramento, CA 95816-4311 - Phone
- (916) 554-0500
- NPI assigned
- Aug 31, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 42954 | CA | Primary |
Addresses
Primary practice location
2830 I St
Suite 105
Sacramento, CA 95816-4311
Mailing address
2830 I St
Suite 105
Sacramento, CA 95816-4311
Phone (916) 554-0500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2678 | Other | CA | MEDI-CAL STAFF NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 2, 2024 through Jan 2, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 42954 | CA | MD | Marriage & Family Therapist |
| 42954 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1391558400000",
"number": "1063523876",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2830 I ST",
"address_2": "SUITE 105",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958164311",
"telephone_number": "916-554-0500"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2830 I ST",
"address_2": "SUITE 105",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958164311",
"telephone_number": "916-554-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WETZEL",
"first_name": "TIFFANY",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-31",
"last_updated": "2014-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 42954",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL STAFF NUMBER",
"identifier": "2678",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.