Active NPI
Kathleen Grace Stutz, MFT
- Marriage & Family Therapist
- Fairfield, CA
National Provider Identifier
1407910656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 46746
- Practice address
- 1300 Oliver Rd
Suite 193
Fairfield, CA 94534-3413 - Phone
- (707) 548-4332
- NPI assigned
- Dec 21, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 46746 | CA | Primary |
Addresses
Primary practice location
1300 Oliver Rd
Suite 193
Fairfield, CA 94534-3413
Mailing address
PO Box 422
Elmira, CA 95625-0422
Phone (707) 548-4332
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4438 | Other | CA | MENTAL HEALTH |
| 1454 | Other | CA | NNA |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241001002453 | CA | Practitioner - Marriage and Family Therapist | 1456882422 | Practice locations: Vacaville, CA |
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
795 Alamo Dr
Suite 2a
Vacaville, CA 95688-5300
Phone (707) 548-4332
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 46746 | CA | MD | Marriage & Family Therapist |
| 46746 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166659200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282521600000",
"number": "1407910656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 422",
"city": "ELMIRA",
"state": "CA",
"postal_code": "956250422",
"telephone_number": "707-548-4332"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 OLIVER RD",
"address_2": "SUITE 193",
"city": "FAIRFIELD",
"state": "CA",
"postal_code": "945343413",
"telephone_number": "707-548-4332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUTZ",
"first_name": "KATHLEEN",
"middle_name": "GRACE",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-21",
"last_updated": "2010-08-23",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 46746",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MENTAL HEALTH",
"identifier": "4438",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NNA",
"identifier": "1454",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fairfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2010; 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.