Active NPI
Jenifer Butera, LMFT
- Marriage & Family Therapist
- Davis, CA
National Provider Identifier
1982925616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC39219
- Practice address
- 1260 Lake Blvd
Suite 242
Davis, CA 95616-2614 - Phone
- (530) 771-2308
- Fax
- (530) 771-2309
- NPI assigned
- Jun 16, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC39219 | CA | Primary |
Addresses
Primary practice location
1260 Lake Blvd
Suite 242
Davis, CA 95616-2614
Mailing address
1260 Lake Blvd
Suite 242
Davis, CA 95616-2614
Phone (530) 771-2308
Other names 1
- Jenny Butera
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 20, 2025 through Feb 20, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC39219 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1982925616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1260 LAKE BLVD",
"address_2": "SUITE 242",
"city": "DAVIS",
"state": "CA",
"postal_code": "956162614",
"telephone_number": "530-771-2308",
"fax_number": "530-771-2309"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1260 LAKE BLVD",
"address_2": "SUITE 242",
"city": "DAVIS",
"state": "CA",
"postal_code": "956162614",
"telephone_number": "530-771-2308",
"fax_number": "530-771-2309"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUTERA",
"first_name": "JENIFER",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-16",
"last_updated": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC39219",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "906 G St., Ste. 400 & 500",
"city": "Sacramento",
"state": "CA",
"country_code": "US",
"postal_code": "95814",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNY",
"last_name": "BUTERA",
"credential": "MFT",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Davis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.