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

Mr. Kenneth Michael Pettis Jr., LMFT

Individual provider Marriage & Family Therapist · NPI 1699485540

Mr. Kenneth Michael Pettis Jr., LMFT is a Marriage & Family Therapist in Lodi, California. Licensed in California. Registered with an NPI since 2022.

Licensed in
CA
In the registry since
2022
What do these letters mean?
LMFT — Licensed Marriage and Family Therapist
A therapist licensed to treat couples and families.

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Practice location Address checks out

315 W Pine St #3 95240
Lodi, CA 95240-4094
Phone: (209) 366-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 150072 (CA)

Record details

NPI number1699485540
Entity typeIndividual (Type 1)
GenderMale
Credentials LMFT
Sole proprietorNo
NPI enumeratedDecember 1, 2022
Last updated in NPPESOctober 15, 2024
Certification dateOctober 15, 2024

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