Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Katherine Pettibone, DPM

Individual provider Podiatrist · NPI 1740773035

Dr. Katherine Pettibone, DPM is a Podiatry in Santa Rosa, California. Graduated from California School of Podiatric Medicine in 2014, 12 years ago. Practices with Permanente Medical Group Inc, a 10,941-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
12
Trained at
California School of Podiatric Medicine
Licensed in
CA
In the registry since
2018
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

2240 Mercury Way
Santa Rosa, CA 95407-5413
Phone: (707) 570-3120
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence E5743 (CA)

Record details

NPI number1740773035
Entity typeIndividual (Type 1)
GenderFemale
Credentials DPM
Sole proprietorNo
NPI enumeratedJune 11, 2018
Last updated in NPPESApril 6, 2022
Certification dateApril 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolCALIFORNIA SCHOOL OF PODIATRIC MEDICINE
Graduated 2014 (12 years in practice)
Group practice Permanente Medical Group Inc — 10941 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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