Individual provider Active NPI

Jesse Whittle-Utter, MFT

  • Marriage & Family Therapist
  • Oakland, CA
National Provider Identifier
1841511649
Registry record updated Sep 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
79783 Issued in CA
Practice address
3852 Piedmont Ave
Oakland, CA 94611-5353
Phone
(510) 740-8024
NPI assigned
Jun 15, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2014

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 79783 CA Primary

Addresses

Primary practice location

3852 Piedmont Ave
Oakland, CA 94611-5353

Mailing address

3852 Piedmont Ave
Oakland, CA 94611-5353
Phone (510) 740-8024

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 10, 2024 through Apr 10, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
79783CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410825600000",
    "number": "1841511649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3852 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115353",
            "telephone_number": "510-740-8024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3852 PIEDMONT AVE",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946115353",
            "telephone_number": "510-740-8024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTLE-UTTER",
        "first_name": "JESSE",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2014-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "79783",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, CA

Sources for this page

Verify at the official NPI Registry.