Michelle Rae Witt, MF
Individual provider Active NPI Marriage & Family Therapist · Sloughhouse, CA
NPI 1891933016 · NPPES record last updated Jan 26, 2009
Key facts
- NPI
- 1891933016
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 40932 (CA)
- Practice address
- 14049 Boys Ranch Rd
Sloughhouse, CA 95683-9782 - Phone
- (916) 294-0629
- NPI assigned
- Jan 26, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 40932 | CA | MD | Pulmonary Rehabilitation Certified Respiratory Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 40932 | CA | Yes |
Addresses
Primary practice location
14049 Boys Ranch Rd
Sloughhouse, CA 95683-9782
Mailing address
14049 Boys Ranch Rd
Sloughhouse, CA 95683-9782
Phone (916) 294-0629
NPI Registry JSON
{
"created_epoch": "1232928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1232928000000",
"number": "1891933016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14049 BOYS RANCH RD",
"city": "SLOUGHHOUSE",
"state": "CA",
"postal_code": "956839782",
"telephone_number": "916-294-0629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14049 BOYS RANCH RD",
"city": "SLOUGHHOUSE",
"state": "CA",
"postal_code": "956839782",
"telephone_number": "916-294-0629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WITT",
"first_name": "MICHELLE",
"middle_name": "RAE",
"credential": "MF",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-01-26",
"last_updated": "2009-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "40932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sloughhouse, CA
All providers in Sloughhouse, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.