NPIMap

Organization Active NPI

Sactown Therapy LLC

Doing business as SacTown Therapy

  • Marriage & Family Therapist
  • Fair Oaks, CA
National Provider Identifier
1417740473
Registry record updated May 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
SACTOWN THERAPY LLC
Doing business as
SacTown Therapy
Practice address
4070 Bridge St Ste 3
Fair Oaks, CA 95628-7557
Phone
(415) 320-0141
Fax
(916) 357-9111
NPI assigned
May 23, 2025
Last updated
May 23, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2025

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

Authorized official

Name
Dr. Dr Kellen R Grayson, PSY.D. LMFT
Title
Ceo
Phone
(415) 320-0141

Specialties & licenses 1

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

Addresses

Primary practice location

4070 Bridge St Ste 3
Fair Oaks, CA 95628-7557

Mailing address

4070 Bridge St Ste 3
Fair Oaks, CA 95628-7557
Phone (415) 320-0141

Other names 1

  • SacTown Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

4070 Bridge St
Ste 3
Fair Oaks, CA 95628
Phone (415) 320-0141

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1747958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747958400000",
    "number": "1417740473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 BRIDGE ST STE 3",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287557",
            "telephone_number": "415-320-0141",
            "fax_number": "916-357-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4070 BRIDGE ST STE 3",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287557",
            "telephone_number": "415-320-0141",
            "fax_number": "916-357-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACTOWN THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-23",
        "last_updated": "2025-05-23",
        "certification_date": "2025-05-23",
        "status": "A",
        "authorized_official_last_name": "GRAYSON",
        "authorized_official_first_name": "DR KELLEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "415-320-0141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D. LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SacTown Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.