Active NPI
Kenneth Ray McPeters
- Marriage & Family Therapist
- Stockton, CA
National Provider Identifier
1649552654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 48999
- Practice address
- 8900 Thornton Rd Ste 6
Stockton, CA 95209-1820 - Phone
- (209) 609-6770
- NPI assigned
- Sep 15, 2011
- Sex
- Male
- 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 | 48999 | CA | Primary |
Addresses
Primary practice location
8900 Thornton Rd Ste 6
Stockton, CA 95209-1820
Mailing address
10420 Almanor Cir
Stockton, CA 95219-7101
Phone (209) 609-6770
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 48999 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1649552654",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10420 ALMANOR CIR",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952197101",
"telephone_number": "209-609-6770",
"fax_number": "209-476-8626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8900 THORNTON RD STE 6",
"city": "STOCKTON",
"state": "CA",
"postal_code": "952091820",
"telephone_number": "209-609-6770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCPETERS",
"first_name": "KENNETH",
"middle_name": "RAY",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-09-15",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "48999",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stockton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.