Individual provider Active NPI

Kezia A Hatfield, LMFT

  • Marriage & Family Therapist
  • Redlands, CA
National Provider Identifier
1083130132
Registry record updated Dec 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
12 Nevada St Ste B
Redlands, CA 92373
Phone
(530) 710-8037
Fax
(951) 848-6277
NPI assigned
Aug 21, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2018

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

12 Nevada St Ste B
Redlands, CA 92373

Mailing address

12 Nevada St Ste B
Redlands, CA 92373-4222
Phone (530) 710-8037

Other practice location 1

1415 Victor Ave
Redding, CA 96003-4879
Phone (530) 338-6549

Other identifiers 1

IdentifierTypeStateIssuer
100698OtherCALMFT

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
I20240306001208 CA Practitioner - Marriage and Family Therapist 6305282948 Practice locations: Redlands, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

12 Nevada St
Suite B
Redlands, CA 92373-4222
Phone (530) 710-8037

12 Nevada St B
Redlands, CA 92373-4222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
100698CAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545955200000",
    "number": "1083130132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 NEVADA ST STE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923734222",
            "telephone_number": "530-710-8037",
            "fax_number": "951-848-6277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NEVADA ST STE B",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "530-710-8037",
            "fax_number": "951-848-6277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 Victor Ave",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960034879",
            "country_code": "US",
            "telephone_number": "530-338-6549",
            "fax_number": "530-605-0281",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HATFIELD",
        "first_name": "KEZIA",
        "middle_name": "A",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2018-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LMFT",
            "identifier": "100698",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.