Individual provider Active NPI

Rebecca Diane Kohle-Patterson, LMFT

  • Marriage & Family Therapist
  • Santa Maria, CA
National Provider Identifier
1053519330
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
52241 Issued in CA
Practice address
116 Agnes Ave
Santa Maria, CA 93458-2838
Phone
(805) 457-3724
NPI assigned
Jul 6, 2007
Last updated
Mar 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RASP0412271036 CA
Marriage & Family Therapist 106H00000X 52241 CA Primary

Addresses

Primary practice location

116 Agnes Ave
Santa Maria, CA 93458-2838

Mailing address

116 Agnes Ave
Santa Maria, CA 93458-2838
Phone (805) 457-3724

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
I20250313001847 CA Practitioner - Marriage and Family Therapist 8325560824 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cyti Health PCGroup PAC ID 4587012950, 34 clinicians

Practice addresses (Care Compare)

11801 Pierce St
Riverside, CA 92505-4408
Phone (866) 478-3978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RASP0412271036CAMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Telecare Corporation CurrentSince Mar 26, 2023 Accepting new patients
Cyti Health PC CurrentSince Jan 5, 2025 Accepting new patients

Locations

11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317

402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939

3111 Camino del Rio N
Ste 460
San Diego, CA 92108

116 Agnes Ave
Santa Maria, CA 93458
Phone (805) 212-7680

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1053519330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 AGNES AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582838",
            "telephone_number": "805-457-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 AGNES AVE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582838",
            "telephone_number": "805-457-3724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOHLE-PATTERSON",
        "first_name": "REBECCA",
        "middle_name": "DIANE",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RASP0412271036",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "52241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Maria, CA

Sources for this page

Verify at the official NPI Registry.