Kathleen Bornino, MFT
Individual provider Active NPI Marriage & Family Therapist · Arroyo Grande, CA
NPI 1013936129 · NPPES record last updated Jan 20, 2024
Key facts
- NPI
- 1013936129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- MFT24821 (CA)
- Practice address
- 1183 Shannon LN
Arroyo Grande, CA 93420-5147 - Phone
- (805) 481-1724
- Fax
- (805) 473-3853
- NPI assigned
- Jul 19, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Marriage and Family Therapist
- Education
- Other, 1971
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1183 Shannon LN
Arroyo Grande, CA 93420-5147
Phone (805) 481-1724
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240221001659 | CA | Practitioner - Marriage and Family Therapist | 6709220460 | Practice locations: Arroyo Grande, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT24821 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFT24821 | CA | Yes |
Addresses
Primary practice location
1183 Shannon LN
Arroyo Grande, CA 93420-5147
Mailing address
1183 Shannon LN
Arroyo Grande, CA 93420-5147
Phone (805) 481-1724
Other names
- Kathy Bornino
Other providers in Arroyo Grande, CA
- Bluebird Behavior Support LLC
- Brent Robert Bluett
- Megan Bochum
- Kathryn Joan Boland
- Lynnette Borgman
- Michael Bosio
- Brittany Bovee
- Wilfred Gordon Bowman Jr.
- Dorthy A Boyce
- Evelyn Mary Boyle
All providers in Arroyo Grande, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 20, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.