Stacey Kathleen Bottoms, AMFT
Individual provider Active NPI Marriage & Family Therapist · Dixon, CA
NPI 1972156362 · NPPES record last updated Jan 15, 2026
Key facts
- NPI
- 1972156362
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 155264 (CA)
- Practice address
- 1455 Roosevelt St
Dixon, CA 95620-4907 - Phone
- (707) 344-0699
- NPI assigned
- Jul 24, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 2020
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1041 E Yorba Linda Blvd
Suite 202
Placentia, CA 92870-3760
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260206003294 | CA | Practitioner - Marriage and Family Therapist | 0143709451 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 155264 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Forward Wellness Family Therapy, Inc. | Current |
Accepting new patients |
Locations
1041 E Yorba Linda Blvd
Ste 202
Placentia, CA 92870
Phone (714) 579-0717
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 155264 | CA | Yes |
Addresses
Primary practice location
1455 Roosevelt St
Dixon, CA 95620-4907
Mailing address
1455 Roosevelt St
Dixon, CA 95620-4907
Phone (707) 344-0699
Other providers in Dixon, CA
- B811 Medical Transportation Service
- Devin Robinette Baker
- Beverly 811, LLC
- Katie Michelle Birmingham
- Brian Austin Blair
- Angelina Brewer
- Kaylee Bubar
- Martin Bui
- Jaime Gloria Caluya
- Stacey Rose Cames
All providers in Dixon, 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 15, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.