Jill Pettegrew, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT94476 Issued in CA

Practice address

1450 Civic CT Ste 200
Concord, CA 94520

Phone

(925) 671-0777

NPI assigned

Jan 6, 2014

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 14, 2024 through Jan 14, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• We Care Services for Children

  • Community/Behavioral Health Agency
  • Concord, CA
  • NPI 1275750218
  NPD (past)

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

{
    "created_epoch": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526342400000",
    "number": "1306268685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3623 WISCONSIN ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946191541",
            "telephone_number": "510-290-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CIVIC CT STE 200",
            "city": "CONCORD",
            "state": "CA",
            "postal_code": "94520",
            "telephone_number": "925-671-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTEGREW",
        "first_name": "JILL",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2018-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT94476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lily Anne Peterson
• Michela Marie Peterson
• Spencer Peterson
• Hannah Ashley Petrlich
• Rashida Petrovich
• Elisabeth Mary Petterson, RN
• Shyeaka Pettigrew
• Daniel Michael Pezel
• Corey Pfeiffer
• Cindy Pham, RN, PHN

• Marriage & Family Therapist in Concord, CA
• Providers in Concord, 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 May 15, 2018; 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.

Verify at the official NPI Registry.