Individual provider Active NPI

Tessa Alexis Wendell

  • Marriage & Family Therapist
  • El Dorado Hills, CA
National Provider Identifier
1831840719
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
138975 Issued in CA
Practice address
1037 Suncast LN Ste 110
El Dorado Hills, CA 95762-9657
Phone
(916) 467-9539
NPI assigned
Jan 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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 138975 CA Primary

Addresses

Primary practice location

1037 Suncast LN Ste 110
El Dorado Hills, CA 95762-9657

Mailing address

1037 Suncast LN Ste 110
El Dorado Hills, CA 95762-9657
Phone (916) 467-9539

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

LicenseStateTypeSpecialty
138975CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kim Burris, Marriage and Family Therapy, Inc. Marriage & Family Therapist CurrentSince Oct 15, 2023 Accepting new patients

Locations

1037 Suncast Ln
Ste 110
El Dorado Hills, CA 95762
Phone (415) 797-4276

Organizations & group practices 1

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": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1831840719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1037 SUNCAST LN STE 110",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629657",
            "telephone_number": "916-467-9539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1037 SUNCAST LN STE 110",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957629657",
            "telephone_number": "916-467-9539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENDELL",
        "first_name": "TESSA",
        "middle_name": "ALEXIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "138975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.