Joann Adele Depetro, M.A., MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MS12371 Issued in CA

Practice address

2099 Mt Diablo Blvd
Suite 202
Walnut Creek, CA 94596-8495

Phone

(925) 945-0167

Fax

(925) 945-0346

NPI assigned

Oct 28, 2013

Last updated

Oct 28, 2013By 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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 1, 2024 through Jan 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1382918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382918400000",
    "number": "1306274485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2099 MT DIABLO BLVD",
            "address_2": "SUITE 202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968495",
            "telephone_number": "925-945-0167",
            "fax_number": "925-945-0346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2099 MT DIABLO BLVD",
            "address_2": "SUITE 202",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "945968495",
            "telephone_number": "925-945-0167",
            "fax_number": "925-945-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPETRO",
        "first_name": "JOANN",
        "middle_name": "ADELE",
        "name_prefix": "Ms.",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-28",
        "last_updated": "2013-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MS12371",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Camille Denton, M.A.
• Stephen John Dentone, O.D.
• Agnieszka Depinska, MS, RD
• Derek Jue MD
• Stefanie Loreine Derrick
• James P Derum, PA-C
• Toral M. Desai, P.T.

• Marriage & Family Therapist in Walnut Creek, CA
• Providers in Walnut Creek, 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 Oct 28, 2013; 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.