Individual provider Active NPI

Kim Kerr

  • Marriage & Family Therapist
  • Livermore, CA
National Provider Identifier
1073078192
Registry record updated Feb 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
2222 Second St Ste 15
Livermore, CA 94550-4555
Phone
(925) 290-7020
NPI assigned
Feb 2, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 2, 2019

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

Specialties & licenses 1

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

Addresses

Primary practice location

2222 Second St Ste 15
Livermore, CA 94550-4555

Mailing address

4975 Janet CT
Livermore, CA 94550-8514

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 28, 2024 through Dec 28, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
97277CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1549065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549065600000",
    "number": "1073078192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4975 JANET CT",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945508514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2222 SECOND ST STE 15",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945504555",
            "telephone_number": "925-290-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERR",
        "first_name": "KIM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-02",
        "last_updated": "2019-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livermore, CA

Sources for this page

Verify at the official NPI Registry.