Individual provider Active NPI

Penny Fellbrich, MFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1346593043
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
50316 Issued in CA
Practice address
3150 18TH St
San Francisco, CA 94110-2074
Phone
(415) 967-3669
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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 50316 CA Primary

Addresses

Primary practice location

3150 18TH St
San Francisco, CA 94110-2074

Mailing address

502 Andover St
San Francisco, CA 94110-6014
Phone (415) 967-3669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 20, 2025 through Nov 20, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
50316CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1350518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1346593043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 ANDOVER ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941106014",
            "telephone_number": "415-967-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 18TH ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941102074",
            "telephone_number": "415-967-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELLBRICH",
        "first_name": "PENNY",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-18",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "50316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.