Kyle Pettit, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT128417 Issued in CA

Practice address

2570 N 1St St FL 2
San Jose, CA 95131-1035

Phone

(541) 512-7957

NPI assigned

Jan 5, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1841951480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2570 N 1ST ST FL 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311035",
            "telephone_number": "541-512-7957"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 N 1ST ST FL 2",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951311035",
            "telephone_number": "541-512-7957"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "KYLE",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT128417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tigran Petrosyan
• Mirena Petrous, RN
• Craig Alan Pettengill, D.D.S.
• Katrina Larea Pettersen, LEP 4489
• Timothy William Pettett, SUDRC #16547
• Mahleiah Amele Pettus-Johnson
• Manju Simha Petty, LMFT
• Steve Petty, MD
• Yoko Petty
• Andrew John Petulla, P.T.

• Marriage & Family Therapist in San Jose, CA
• Providers in San Jose, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.