Active NPI
Barbara Petterson, MFT
- Marriage & Family Therapist
- Oakland, CA
National Provider Identifier
1649497645
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 25764
- Practice address
- 3873 Piedmont Ave
Suite 5
Oakland, CA 94611-5367 - Phone
- (510) 501-9192
- NPI assigned
- Apr 19, 2007
- 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 | 25764 | CA | Primary |
Addresses
Primary practice location
3873 Piedmont Ave
Suite 5
Oakland, CA 94611-5367
Mailing address
4123 Broadway # 232
Oakland, CA 94611-5111
Phone (510) 501-9192
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 30, 2025 through Jan 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25764 | CA | MD | Other Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1352937600000",
"number": "1649497645",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4123 BROADWAY # 232",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115111",
"telephone_number": "510-501-9192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3873 PIEDMONT AVE",
"address_2": "SUITE 5",
"city": "OAKLAND",
"state": "CA",
"postal_code": "946115367",
"telephone_number": "510-501-9192"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTERSON",
"first_name": "BARBARA",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-19",
"last_updated": "2012-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "25764",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.