Individual provider Active NPI

Serenity Wehrenberg

  • Marriage & Family Therapist
  • Sebastopol, CA
National Provider Identifier
1992150973
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127514 Issued in CA
Practice address
7765 Healdsburg Ave Ste 17
Sebastopol, CA 95472-3310
Phone
(707) 356-0100
NPI assigned
Apr 27, 2016
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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 127514 CA Primary

Addresses

Primary practice location

7765 Healdsburg Ave Ste 17
Sebastopol, CA 95472-3310

Mailing address

40 Fourth St. #287
Petaluma, CA 94952

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jun 17, 2026 through Jun 17, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
127514CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Institute for Psychotherapy Past Accepting new patients
Community Institute for Psychotherapy Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1461715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1992150973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FOURTH ST. #287",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7765 HEALDSBURG AVE STE 17",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954723310",
            "telephone_number": "707-356-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEHRENBERG",
        "first_name": "SERENITY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-27",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastopol, CA

Sources for this page

Verify at the official NPI Registry.