Individual provider Active NPI

Karen B Nemrow

  • Marriage & Family Therapist
  • Petaluma, CA
National Provider Identifier
1336335652
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
54762 Issued in CA
Practice address
1 Bodega Ave
Suite 2
Petaluma, CA 94952-2666
Phone
(707) 765-4999
NPI assigned
Sep 20, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 54762 CA Primary

Addresses

Primary practice location

1 Bodega Ave
Suite 2
Petaluma, CA 94952-2666

Mailing address

1 Bodega Ave
Suite 2
Petaluma, CA 94952-2666
Phone (707) 765-4999

Medicare participation

Medicare enrollment files
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
54762CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1336335652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 BODEGA AVE",
            "address_2": "SUITE 2",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522666",
            "telephone_number": "707-765-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BODEGA AVE",
            "address_2": "SUITE 2",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522666",
            "telephone_number": "707-765-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEMROW",
        "first_name": "KAREN",
        "middle_name": "B",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.