Active NPI
Kay Vettenburg
- Marriage & Family Therapist
- Sacramento, CA
National Provider Identifier
1215993589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF79210
- Practice address
- 1500 21St St
Sacramento, CA 95811-5216 - Phone
- (916) 443-3299
- NPI assigned
- Apr 25, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF79210 | CA | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | CATCV0414201935 | CA |
Addresses
Primary practice location
1500 21St St
Sacramento, CA 95811-5216
Mailing address
1500 21St St
Sacramento, CA 95811-5216
Phone (916) 443-3299
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CATCV0414201935 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| IMF79210 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145923200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487548800000",
"number": "1215993589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 21ST ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958115216",
"telephone_number": "916-443-3299"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 21ST ST",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "958115216",
"telephone_number": "916-443-3299"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VETTENBURG",
"first_name": "KAY",
"name_prefix": "Ms.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-25",
"last_updated": "2017-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF79210",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "CATCV0414201935",
"primary": false
}
],
"identifiers": [],
"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 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.