Individual provider Active NPI

Tatyana Peterson

  • Marriage & Family Therapist
  • Bakersfield, CA
National Provider Identifier
1093108292
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
104560 Issued in CA
Practice address
1401 L St
Bakersfield, CA 93301-4522
Phone
(661) 868-6100
NPI assigned
Mar 12, 2015
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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 104560 CA Primary

Addresses

Primary practice location

1401 L St
Bakersfield, CA 93301-4522

Mailing address

1401 L St
Bakersfield, CA 93301-4522
Phone (661) 868-6100

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
I20240117001365 CA Practitioner - Marriage and Family Therapist 1052763810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
County of KernGroup PAC ID 7810887205, 75 clinicians

Practice addresses (Care Compare)

1401 L St
Bakersfield, CA 93301-4522
Phone (661) 868-6600

2001 28TH St
Bakersfield, CA 93301-1924
Phone (661) 868-6600

2525 N Chester Ave
Bakersfield, CA 93308-1770
Phone (661) 868-1800

3300 Truxtun Ave
Bakersfield, CA 93301-3143

PO Box
Suite 1000
Bakersfield, CA 93301

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
County of Kern Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
County of Kern Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
County of Kern Marriage & Family Therapist Current Accepting new patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Aug 1, 2025 Accepting new patients

Locations

2525 N Chester Ave
Bakersfield, CA 93308
Phone (661) 328-4295

4633 Old Ironsides Dr
Ste 304
Santa Clara, CA 95054
Phone (501) 271-9428

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1093108292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 L ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933014522",
            "telephone_number": "661-868-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 L ST",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933014522",
            "telephone_number": "661-868-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "TATYANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-12",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "104560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

Verify at the official NPI Registry.