Individual provider Active NPI

Gurkirit Jhawar-Terris, MFT

  • Marriage & Family Therapist
  • Petaluma, CA
National Provider Identifier
1902165376
Registry record updated Mar 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 51399 Issued in CA
Practice address
5 Keller St Ste D
Petaluma, CA 94952-2350
Phone
(707) 776-6513
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2018

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 MFC 51399 CA Primary

Addresses

Primary practice location

5 Keller St Ste D
Petaluma, CA 94952-2350

Mailing address

5 Keller St Ste D
Petaluma, CA 94952-2350
Phone (707) 776-6513

Other names 1

  • Kitu Jhawar-Terris Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Previously, effective Sep 15, 2024 through Sep 15, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 51399CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521331200000",
    "number": "1902165376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 KELLER ST STE D",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522350",
            "telephone_number": "707-776-6513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 KELLER ST STE D",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "949522350",
            "telephone_number": "707-776-6513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JHAWAR-TERRIS",
        "first_name": "GURKIRIT",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2018-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 51399",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KITU",
            "last_name": "JHAWAR-TERRIS",
            "credential": "MFT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Petaluma, CA

Sources for this page

Verify at the official NPI Registry.