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KATHERINE DICKERSON
NPI 1659120855
Marriage & Family Therapist in Roseville, CA

Active since May 18, 2024PECOS Enrolled
1382 BLUE OAKS BLVD STE 213, ROSEVILLE, CA 95678(877) 412-8031 Get Directions Write a Review

NPPES record last updated: May 18, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Katherine Dickerson NPPES

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

KATHERINE DICKERSON (NPI 1659120855) is an individual marriage & family therapist in Roseville, California, licensed in California (131426) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS, maintains a secondary practice location in San Diego, and is a graduate of National University Of Arts And Sciences, Medical Department (2022).

NPPES Registry Identity

NPI1659120855
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKATHERINE DICKERSON
Location Address1382 BLUE OAKS BLVD STE 213Roseville, CA 95678-7052
Mailing Address7151 Colony RdLa Mesa, CA 91942-8523
Phone(877) 412-8031
Sole ProprietorNo
Medical School CMSNational University Of Arts And Sciences, Medical DepartmentGraduated 2022
Enumeration DateMay 18, 2024
NPPES CertifiedMay 18, 2024
✔ NPI 1659120855 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 · 131426
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.
1382 BLUE OAKS BLVD STE 213, Roseville, CA 95678
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Secondary Practice Location 1

Location 13914 Murphy Canyon Rd Ste A218San Diego, CA 92123-4423 · Phone (877) 412-8031

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Dickerson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8729552500
PECOS Enrollment IDI20260702000618
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 Katherine Dickerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
103 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 20

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

DESIREE RAKELA
Marriage & Family Therapist
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (916) 741-0565
NIKKI LANE
Counselor (Mental Health)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (877) 412-8031
IVUOMA UMOZURIKE
Health and Wellness Coach
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (877) 412-8031
MRS. BLANCA ZOBEYDA THUN MA, APCC
Counselor (Mental Health)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (916) 400-0533
ROBYN GONZALES
Counselor (Mental Health)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (877) 412-8031
PAYTON GIBO DENNY M.A
Counselor (Mental Health)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (877) 412-8031
JESSICA ANGULO-VALENZUELA LCSW
Social Worker (Clinical)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (805) 305-7656
JESSICA TORRES
Counselor (Mental Health)
1382 BLUE OAKS BLVD STE 213
ROSEVILLE, CA 95678
Placer County (916) 908-8196

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 Katherine Dickerson's NPI number?

The NPI number for Katherine Dickerson is 1659120855. It was assigned to this individual provider in the NPPES registry on May 18, 2024.

Where is Katherine Dickerson located?

Katherine Dickerson practices at 1382 Blue Oaks Blvd Ste 213, Roseville, CA 95678. The listed phone number is (877) 412-8031.

What is Katherine Dickerson's specialty?

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

Is Katherine Dickerson enrolled in Medicare?

Yes. Katherine Dickerson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katherine Dickerson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Dickerson 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 Katherine Dickerson'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 Katherine Dickerson was last updated on May 18, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.