Individual provider Active NPI

Kristen Branch Winslow, LMFT, MBA

  • Marriage & Family Therapist
  • Venice, CA
National Provider Identifier
1083034599
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
80007 Issued in CA
Practice address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone
(310) 392-3070
Fax
(310) 392-9068
NPI assigned
Apr 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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 80007 CA Primary

Addresses

Primary practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Mailing address

503 Ocean Front Walk
Venice, CA 90291-2403
Phone (310) 392-3070

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
I20240404000299 CA Practitioner - Marriage and Family Therapist 9638517014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Business Administration

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Mar 1, 2024 Accepting new patients
Phoenix Houses of Los Angeles, Inc. Past Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1083034599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070",
            "fax_number": "310-392-9068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070",
            "fax_number": "310-392-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINSLOW",
        "first_name": "KRISTEN",
        "middle_name": "BRANCH",
        "name_prefix": "Mrs.",
        "credential": "LMFT, MBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "80007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

Verify at the official NPI Registry.