Roger Dale Peters, MH CLINICIAN II-MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC51816 Issued in CA

Practice address

330 McHenry Ave
Modesto, CA 95354-0561

Phone

(209) 577-3595

Fax

(209) 577-4150

NPI assigned

Feb 7, 2007

Sex

Male

Sole proprietor

Yes

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Total Life Ca PCGroup PAC ID 3173989332, 34 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Total Life Ca, P.C.

  • Cognitive & Behavioral Psychologist
  • Los Angeles, CA
  • NPI 1689389603
  Medicare reassignment Care Compare group NPD
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352332800000",
    "number": "1952441966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2184 ROTHBURY COURT",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822980",
            "telephone_number": "209-667-4098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MCHENRY AVE",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953540561",
            "telephone_number": "209-577-3595",
            "fax_number": "209-577-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERS",
        "first_name": "ROGER",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "MH CLINICIAN II-MFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2012-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "42865",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC51816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pete Herron
• Peter K. Sien, MD, Inc.
• Peter S. Klem Fred P. Guarcello PTR
• Amber K Peters-Briggs
• Laura Peters
• Tom Ferenczik Peters
• Amy Janelle Petersen, NP
• Hannah Peterson-Padilla
• Amanda Peterson
• Andrea Marie Peterson, CPNP-PC

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, 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 Nov 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.