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KIMETHA LAURIE PETTEWAY-TURNER LMFT
NPI 1336866912
Marriage & Family Therapist in Lynwood, CA

Active since October 24, 2022PECOS EnrolledAccepts Medicare Assignment
12627 OAK ST, LYNWOOD, CA 90262(562) 212-8284 Get Directions Write a Review

NPPES record last updated: October 24, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kimetha Laurie Petteway-turner Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMETHA LAURIE PETTEWAY-TURNER LMFT (NPI 1336866912) is an individual marriage & family therapist in Lynwood, California, licensed in California (LMFT115686) and active in the NPI registry since October 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2007).

NPPES Registry Identity

NPI1336866912
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKIMETHA LAURIE PETTEWAY-TURNERCredential: LMFT
Location Address12627 OAK STLynwood, CA 90262-5019
Mailing Address145 Racquet Club DrCompton, CA 90220-3183 · (562) 212-8284
Phone(562) 212-8284
Sole ProprietorYes
Medical School CMSOtherGraduated 2007
Enumeration DateOctober 24, 2022
NPPES CertifiedOctober 24, 2022
✔ NPI 1336866912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · LMFT115686
Definition
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.
12627 OAK ST, Lynwood, CA 90262
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimetha Laurie Petteway-turner Lmft is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830667989
PECOS Enrollment IDI20260506003205
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimetha Petteway-turner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
320 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CHARZETTA FUNDERBURK
Marriage & Family Therapist
12627 OAK ST
LYNWOOD, CA 90262
Los Angeles County (562) 206-4740

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimetha Petteway-turner's NPI number?

The NPI number for Kimetha Petteway-turner is 1336866912. It was assigned to this individual provider in the NPPES registry on October 24, 2022.

Where is Kimetha Petteway-turner located?

Kimetha Petteway-turner practices at 12627 Oak St, Lynwood, CA 90262. The listed phone number is (562) 212-8284.

What is Kimetha Petteway-turner's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Kimetha Petteway-turner enrolled in Medicare?

Yes. Kimetha Petteway-turner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kimetha Petteway-turner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimetha Petteway-turner reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimetha Petteway-turner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimetha Petteway-turner was last updated on October 24, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.