Individual provider Active NPI

Janette Fetterly, P.T

  • Physical Therapist
  • Auburn, CA
National Provider Identifier
1376910067
Registry record updated Sep 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
34641 Issued in CA
Practice address
11930 Heritage Oak PL Ste 9
Auburn, CA 95603-2458
Phone
(530) 887-8785
NPI assigned
Aug 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL.00013494 CO
Physical Therapist 225100000X 34641 CA Primary
Physical Therapist 225100000X PT60569869 WA

Addresses

Primary practice location

11930 Heritage Oak PL Ste 9
Auburn, CA 95603-2458

Mailing address

PO Box 255228
Sacramento, CA 95865-5228

Other practice location 1

21806 103rd Avenue Ct E
Ste 103
Graham, WA 98338-8115
Phone (253) 847-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240906002025 CA Practitioner - Physical Therapist in Private Practice 3870802945 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burger Physical Therapy Services IncGroup PAC ID 8921019746, 37 clinicians

Practice addresses (Care Compare)

11990 Heritage Oak PL
Suite 8
Auburn, CA 95603-2405
Phone (530) 823-6835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34641CAMDAddiction (Substance Use Disorder) Counselor
PTL.00013494COMDPhysical Therapist
PT60569869WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Burger Physical Therapy Services Inc CurrentSince Jul 1, 2024 Accepting new patients
Burger Physical Therapy and Rehabilitation Agency Inc PastSince Jul 1, 2024 Accepting new patients

Locations

11990 Heritage Oak Pl
Ste 8
Auburn, CA 95603
Phone (530) 823-6835

1301 E Bidwell St
Ste 201
Folsom, CA 95630

7200 S Land Park Dr
Ste 300
Sacramento, CA 95831
Phone (916) 391-5010

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788998400000",
    "number": "1376910067",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 255228",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958655228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11930 HERITAGE OAK PL STE 9",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032458",
            "telephone_number": "530-887-8785"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21806 103rd Avenue Ct E",
            "address_2": "Ste 103",
            "address_purpose": "LOCATION",
            "city": "Graham",
            "state": "WA",
            "postal_code": "983388115",
            "country_code": "US",
            "telephone_number": "253-847-3700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FETTERLY",
        "first_name": "JANETTE",
        "credential": "P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-28",
        "last_updated": "2026-09-10",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL.00013494",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "34641",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WA",
            "license": "PT60569869",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.