Chris Pettinichio

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

564 Mountain Ranch Rd Ste 5
San Andreas, CA 95249-9782

Phone

(530) 626-3105

NPI assigned

Oct 22, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Sierra Child & Family Services

  • Community/Behavioral Health Agency
  • San Andreas, CA
  • NPI 1326647686
  NPD

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

{
    "created_epoch": "1634860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1942964283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1553",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952491553",
            "telephone_number": "209-206-0842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "564 MOUNTAIN RANCH RD STE 5",
            "city": "SAN ANDREAS",
            "state": "CA",
            "postal_code": "952499782",
            "telephone_number": "530-626-3105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTINICHIO",
        "first_name": "CHRIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-22",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Neal Parrish
• Shane Michael Patterson, M.D.
• Karen Pekarcik, LCSW 80071
• Lauren Chandra Peterson
• Gabriel R Pettersen, MD
• Thanh Duc Pham, D.D.S.
• Miguel Picasso
• Tandis Kaye Pourbastani
• Premier Emergency Physicians of California Medical Group PC
• Danielle Lorraine Pullin

• Mental Health Counselor in San Andreas, CA
• Providers in San Andreas, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.