Individual provider Active NPI

Kelsea Embry, MFT TRAINEE, CADC

  • Addiction (Substance Use Disorder) Counselor
  • San Bernardino, CA
National Provider Identifier
1033055660
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
1874 Business Center Dr
San Bernardino, CA 92408-3457
Phone
(909) 386-0523
NPI assigned
Apr 27, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X CA Primary

Addresses

Primary practice location

1874 Business Center Dr
San Bernardino, CA 92408-3457

Mailing address

30414 Town Center Dr Apt 121
Menifee, CA 92584-6871

Other practice location 1

1076 Santo Antonio Dr # Bcd
Colton, CA 92324-8103
Phone (909) 433-9824

Other practice location 2

19192 Turrell Way
Riverside, CA 92508-6607
Phone (951) 387-1884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1777248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1033055660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30414 TOWN CENTER DR APT 121",
            "city": "MENIFEE",
            "state": "CA",
            "postal_code": "925846871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1874 BUSINESS CENTER DR",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083457",
            "telephone_number": "909-386-0523"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1076 Santo Antonio Dr # Bcd",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923248103",
            "country_code": "US",
            "telephone_number": "909-433-9824",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "19192 Turrell Way",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925086607",
            "country_code": "US",
            "telephone_number": "951-387-1884",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMBRY",
        "first_name": "KELSEA",
        "credential": "MFT TRAINEE, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-27",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Bernardino, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.