Individual provider Active NPI

Penne Michelle Larue-Rader

  • Marriage & Family Therapist
  • Chico, CA
National Provider Identifier
1497035869
Registry record updated Jul 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
75675 Issued in CA
Practice address
578 Rio Lindo Ave
Chico, CA 95926-1800
Phone
(530) 894-5933
Fax
(530) 894-5791
NPI assigned
Aug 17, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 99159 CA
Rehabilitation Counselor 225C00000X
Marriage & Family Therapist 106H00000X 75675 CA Primary

Addresses

Primary practice location

578 Rio Lindo Ave
Chico, CA 95926-1800

Mailing address

25885 Santa Rosa Rd
25885 Santa Rosa Rd
Apple Valley, CA 92308-1800
Phone (530) 443-3828

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260220003176 CA Practitioner - Marriage and Family Therapist 4385125038 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mischka Psychological PCGroup PAC ID 5193193159, 2 clinicians

Practice addresses (Care Compare)

15428 Civic Dr
Suite 320
Victorville, CA 92392-2383
Phone (760) 885-0384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
75675CAMDMarriage & Family Therapist
99159CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soul Journey Family Counseling Org CurrentSince Jul 22, 2025 Accepting new patients
Mischka Psychological PC CurrentSince Feb 6, 2026 Accepting new patients

Locations

15428 Civic Dr
Ste 320
Victorville, CA 92392
Phone (442) 229-2042

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": "1313539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752796800000",
    "number": "1497035869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25885 SANTA ROSA RD",
            "address_2": "25885 SANTA ROSA RD",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923081800",
            "telephone_number": "530-443-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 RIO LINDO AVE",
            "city": "CHICO",
            "state": "CA",
            "postal_code": "959261800",
            "telephone_number": "530-894-5933",
            "fax_number": "530-894-5791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARUE-RADER",
        "first_name": "PENNE",
        "middle_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-17",
        "last_updated": "2025-07-18",
        "certification_date": "2025-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "99159",
            "primary": false
        },
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "75675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chico, CA

Sources for this page

Verify at the official NPI Registry.