Individual provider Active NPI

Kimberly Lynn Miller, LMFT

  • Marriage & Family Therapist
  • San Luis Obispo, CA
National Provider Identifier
1053332445
Registry record updated Feb 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC34993 Issued in CA
Practice address
3220 S Higuera St Ste 303
San Luis Obispo, CA 93401-6988
Phone
(805) 235-1585
Fax
(805) 540-7064
NPI assigned
Jul 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC34993 CA Primary
Marriage & Family Therapist 106H00000X 34993 CA

Addresses

Primary practice location

3220 S Higuera St Ste 303
San Luis Obispo, CA 93401-6988

Mailing address

3220 S Higuera St Ste 303
San Luis Obispo, CA 93401-6988
Phone (805) 235-1585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240326003640 CA Practitioner - Marriage and Family Therapist 2163869157 Practice locations: San Luis Obispo, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3220 S Higuera St
Suite 303
San Luis Obispo, CA 93401-6988
Phone (805) 235-1585

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC34993CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kimberly Miller, LMFT, Inc. Marriage & Family Therapist CurrentSince Jan 6, 2024 Accepting new patients

Locations

3220 S Higuera St
Ste 303
San Luis Obispo, CA 93401
Phone (805) 235-1585

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1053332445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3220 S HIGUERA ST STE 303",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016988",
            "telephone_number": "805-235-1585",
            "fax_number": "805-540-7064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3220 S HIGUERA ST STE 303",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934016988",
            "telephone_number": "805-235-1585",
            "fax_number": "805-540-7064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KIMBERLY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC34993",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "34993",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.