Active NPI
Holli Rae Kenley, M.A.
- Marriage & Family Therapist
- La Quinta, CA
National Provider Identifier
1073667200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC39156
- Practice address
- 78150 Calle Tampico
Suite 207a
La Quinta, CA 92253-2907 - Phone
- (760) 397-7978
- Fax
- (760) 564-0300
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC39156 | CA | Primary |
Addresses
Primary practice location
78150 Calle Tampico
Suite 207a
La Quinta, CA 92253-2907
Mailing address
35596 Butterfly Peak Rd
Mountain Center, CA 92561-3067
Phone (760) 397-7978
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 25, 2024 through Jan 25, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC39156 | CA | MD | Marriage & Family Therapist |
| 39156 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1073667200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35596 BUTTERFLY PEAK RD",
"city": "MOUNTAIN CENTER",
"state": "CA",
"postal_code": "925613067",
"telephone_number": "760-397-7978",
"fax_number": "760-564-0300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78150 CALLE TAMPICO",
"address_2": "SUITE 207A",
"city": "LA QUINTA",
"state": "CA",
"postal_code": "922532907",
"telephone_number": "760-397-7978",
"fax_number": "760-564-0300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENLEY",
"first_name": "HOLLI",
"middle_name": "RAE",
"name_prefix": "Mrs.",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC39156",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Quinta, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.