Individual provider · Type 1 NPI

Kenneth Michael Pettis Jr., LMFT

Marriage & Family Therapist · Lodi, CA

NPI number 1699485540 Active

Practice location

315 W Pine St #3, 95240
Lodi, CA 95240-4094

Call (209) 366-2273 Map

Mailing address

5250 Claremont Ave Ste 118
Stockton, CA 95207-5700

Specialties and licenses

TaxonomyCodeLicense
Marriage & Family Therapist Primary 106H00000X150072 (CA)

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 ment…

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About NPI 1699485540

Kenneth Michael Pettis Jr., LMFT's National Provider Identifier is 1699485540, issued on Dec 1, 2022. The primary taxonomy on file is Marriage & Family Therapist (106H00000X), and the practice location is in Lodi, CA. The record was last updated on Oct 15, 2024.