Individual provider Active NPI

Kylie Kellas Cline, LMFT

  • Marriage & Family Therapist
  • Irvine, CA
National Provider Identifier
1053847111
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
92818 Issued in CA
Practice address
17752 Sky Park Cir Ste 210
Irvine, CA 92614-4469
Phone
(714) 584-9018
NPI assigned
May 11, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 120845 CA
Marriage & Family Therapist 106H00000X
Marriage & Family Therapist 106H00000X 92818 CA Primary

Addresses

Primary practice location

17752 Sky Park Cir Ste 210
Irvine, CA 92614-4469

Mailing address

17752 Sky Park Cir Ste 210
Irvine, CA 92614-4469
Phone (714) 584-9018

Other names 1

  • Kylie Jean Kellas Former name

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

State licenses

LicenseStateTypeSpecialty
120845CAMDMental Health Counselor
92818CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Nancy Caltagirone PastSince Aug 30, 2020 Accepting new patients

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": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1053847111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17752 SKY PARK CIR STE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926144469",
            "telephone_number": "714-584-9018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17752 SKY PARK CIR STE 210",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926144469",
            "telephone_number": "714-584-9018"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLAS CLINE",
        "first_name": "KYLIE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "120845",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "92818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KYLIE",
            "last_name": "KELLAS",
            "middle_name": "JEAN",
            "credential": "AMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2023; 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.