Individual provider Active NPI

Julie Pennington, LMFT

  • Marriage & Family Therapist
  • Ukiah, CA
National Provider Identifier
1730415019
Registry record updated Nov 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT108830 Issued in CA
Practice address
776 S State St Ste 109
Ukiah, CA 95482-5833
Phone
(916) 600-8435
NPI assigned
Oct 21, 2009
Last updated
Nov 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT108830 CA Primary

Addresses

Primary practice location

776 S State St Ste 109
Ukiah, CA 95482-5833

Mailing address

776 S State St Ste 109
Ukiah, CA 95482-5833
Phone (916) 600-8435

Other practice location 1

925 Bevins Ct
Lakeport, CA 95453-9754
Phone (707) 263-8382 ext. 1324

Other names 1

  • Julie Pitcher, Colfax Former name

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
I20240916001162 CA Practitioner - Marriage and Family Therapist 3870034093 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2010
Medicare assignment
May accept Medicare assignment
Group practices

Practice addresses (Care Compare)

925 Bevins CT
Lakeport, CA 95453-9754
Phone 70726383821204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT108830CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lake County Tribal Health Southshore Clinic CurrentSince Aug 5, 2024 Accepting new patients
Lake County Tribal Health Consortium Inc. CurrentSince Aug 5, 2024 Accepting new patients

Locations

14440 Olympic Dr
Clearlake, CA 95422
Phone (707) 263-8382

925 Bevins Ct
Lakeport, CA 95453
Phone (707) 263-8382

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1256083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763251200000",
    "number": "1730415019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "776 S STATE ST STE 109",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825833",
            "telephone_number": "916-600-8435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "776 S STATE ST STE 109",
            "city": "UKIAH",
            "state": "CA",
            "postal_code": "954825833",
            "telephone_number": "916-600-8435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "925 Bevins Ct",
            "address_purpose": "LOCATION",
            "city": "Lakeport",
            "state": "CA",
            "postal_code": "954539754",
            "country_code": "US",
            "telephone_number": "707-263-8382 x1324",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENNINGTON",
        "first_name": "JULIE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-21",
        "last_updated": "2025-11-16",
        "certification_date": "2025-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT108830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "PITCHER, COLFAX",
            "credential": "LMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Ukiah, CA

Sources for this page

Verify at the official NPI Registry.