Active NPI
George Peckham, MFT
- Marriage & Family Therapist
- Fair Oaks, CA
National Provider Identifier
1679684997
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT47127
- Practice address
- 8261 Greenback LN # 100
Fair Oaks, CA 95628-2504 - Phone
- (916) 420-6388
- NPI assigned
- Aug 31, 2006
- Last updated
- Apr 3, 2010
- 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 | MFT47127 | CA | Primary |
Addresses
Primary practice location
8261 Greenback LN # 100
Fair Oaks, CA 95628-2504
Mailing address
8261 Greenback LN # 100
Fair Oaks, CA 95628-2504
Phone (916) 420-6388
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 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT47127 | CA | MD | Marriage & Family Therapist |
| 47127 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156982400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1270252800000",
"number": "1679684997",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8261 GREENBACK LN # 100",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956282504",
"telephone_number": "916-420-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8261 GREENBACK LN # 100",
"city": "FAIR OAKS",
"state": "CA",
"postal_code": "956282504",
"telephone_number": "916-420-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PECKHAM",
"first_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-31",
"last_updated": "2010-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT47127",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Apr 3, 2010; 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.