Renee Christine Ketchum

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

125408 Issued in CA

Practice address

8880 Cal Center Dr Ste 400
Sacramento, CA 95826-3267

Phone

(169) 573-8975

NPI assigned

Sep 15, 2017

Last updated

Nov 19, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bay Area Community Services, Inc.

  • Community/Behavioral Health Agency
  • Oakland, CA
  • NPI 1235349572
  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD
• Bay Area Community Services, Inc.

  dba South County Wellness Center

  • Community/Behavioral Health Agency
  • Fremont, CA
  • NPI 1104036383
  NPD
• Bay Area Community Services, Inc.

  • Community/Behavioral Health Agency
  • Sacramento, CA
  • NPI 1982334561
  NPD
• Couples Resource Collective

  • Community/Behavioral Health Agency
  • Sacramento, CA
  • NPI 1144775586
  NPD (past)

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

{
    "created_epoch": "1505433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1245759745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 CAL CENTER DR STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263267",
            "telephone_number": "169-573-8975"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 CAL CENTER DR STE 400",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958263267",
            "telephone_number": "169-573-8975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Fulton Ave Ste 160",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958254517",
            "country_code": "US",
            "telephone_number": "916-426-6567",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Stockton Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958172210",
            "country_code": "US",
            "telephone_number": "916-520-2785",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KETCHUM",
        "first_name": "RENEE",
        "middle_name": "CHRISTINE",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-15",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Kaylynn Kessler
• Kelly Ketcham, M.ED, A.T.C.
• Courtney Ketcherside
• Darcy C Ketchum, M.D.
• John Ketchum
• Saniya Aujaray Ketchum
• Eva Ketron
• Ashley Kettenhofen
• Samantha Kettle, PSY.D.
• Jasmine Kettley, PA-C

• Marriage & Family Therapist in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.