CHARLES WATTENBERG (NPI# 1295268886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295268886 |
| Entity Type | Individual |
| Full Name | CHARLES WATTENBERG |
| Credential | MFT |
| Practice Address |
1301 Redwood Way Suite 223 Petaluma CA 94954-1107 |
| Practice Telephone | 7077622998 |
| Mailing Telephone | 7077622998 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MX18124 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1301 REDWOOD WAY SUITE 223 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-1107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043366198 | Elaine Maria Stevick | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-01-25 |
| 1114536455 | Amber Marie Crego-awwad | Behavior Technician | 1301 Redwood Way, Petaluma, CA 94954-1107 | 2020-07-22 |
| 1831634500 | Kasena Kafka | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2017-01-04 |
| 1174721930 | Karen Demars | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-07-03 |
| 1801019773 | Speech Pathology Services of Marin Sonoma Incorportated | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-04-10 |
| 1083739676 | Alicia Lynn Starrett | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-03-20 |
| 1780719534 | Nancy Schwartz | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-02-22 |
| 1063555035 | Lori S Walker | Speech-Language Pathologist | 1301 Redwood Way, Suite 165, Petaluma, CA 94954-1107 | 2007-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1184106783 | Martin Graff | Marriage & Family Therapist | 855 Lakeville St Ste 108, Petaluma, CA 94952-7328 | 2018-08-30 |
| 1104315845 | Nancy June Goldstein | Marriage & Family Therapist | 134 Grevillia Dr, Petaluma, CA 94952-6110 | 2018-05-08 |
| 1588168405 | Christopher John Ranney | Marriage & Family Therapist | 10 4th St, Petaluma, CA 94952-3004 | 2018-03-23 |
| 1558803288 | Emily Mann | Marriage & Family Therapist | 141 F St, Petaluma, CA 94952-4236 | 2016-11-11 |
| 1932641198 | Heather Sutherland | Marriage & Family Therapist | 1104 Whippoorwill Ct, Petaluma, CA 94954-1815 | 2016-11-04 |
| 1568911964 | Petaluma Family Therapy | Marriage & Family Therapist | 405 E D St Ste 105, Petaluma, CA 94952-3173 | 2016-09-26 |
| 1568824670 | Donald W Waxman | Marriage & Family Therapist | 6 C St, Petaluma, CA 94952-3025 | 2016-03-28 |
| 1245605450 | Rachael Newman | Marriage & Family Therapist | 47 6th St Ste 200, Petaluma, CA 94952-3092 | 2015-12-14 |
| 1477925766 | Tonia Sassi | Marriage & Family Therapist | 174 Windsor Dr, Petaluma, CA 94952-7504 | 2015-10-26 |
| Find all providers in PETALUMA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.