Linda Dianne Petteway, PHD.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 49813 Issued in CA

Practice address

4590 Allstate Dr
Riverside, CA 92501-1702

Phone

(213) 369-0162

NPI assigned

Mar 1, 2007

Last updated

Jun 27, 2023By 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 3

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

Specialty

Marriage and Family Therapist

Education

Other, 1993

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Ubuntu Psychological Services

  • Clinical Psychologist
  • Corona, CA
  • NPI 1871116053
  Medicare reassignment
• McKinley Children's Center

  • Community/Behavioral Health Agency
  • Riverside, CA
  • NPI 1831691880
  NPD
• McKinley Children's Center, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Riverside, CA
  • NPI 1528743846
  NPD

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1336277508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702",
            "telephone_number": "213-369-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4590 ALLSTATE DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925011702",
            "telephone_number": "213-369-0162"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1855 N Fair Oaks Ave",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911031620",
            "country_code": "US",
            "telephone_number": "626-296-7710",
            "fax_number": "626-296-7714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTEWAY",
        "first_name": "LINDA",
        "middle_name": "DIANNE",
        "name_prefix": "Dr.",
        "credential": "PHD.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-01",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49813",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 49813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary James Peterson
• Nequayle Petes
• Brodi Thomas Petitt
• Brian Petry, MA, MBA, LPCC, LMFT
• Kalia Leeanna Petry
• Dylan Pettitt, NONE
• Brooke Petty
• Shannon Petty
• Aniyah C Pewett, NONE
• Harvey Dwayne Pfiefle, MD

• Marriage & Family Therapist in Riverside, CA
• Providers in Riverside, 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 Jun 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.