Individual provider Active NPI

Kevin Michael Andrew Valencia

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1093226029
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
117264 Issued in CA
Practice address
2531 W Woodland Dr
Anaheim, CA 92801-2637
Phone
(714) 226-9888
NPI assigned
Oct 17, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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 117264 CA Primary

Addresses

Primary practice location

2531 W Woodland Dr
Anaheim, CA 92801-2637

Mailing address

2531 W Woodland Dr
Anaheim, CA 92801-2637
Phone (714) 226-9888

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
I20241226002159 CA Practitioner - Marriage and Family Therapist 1052848397 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Live Well Family Counseling ServicesGroup PAC ID 1759814452, 7 clinicians

Practice addresses (Care Compare)

41593 Winchester Rd
Suite 215
Temecula, CA 92590-4841
Phone (951) 257-8045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127274CAMDClinical Social Worker
117264CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Live Well Family Counseling Services Marriage & Family Therapist CurrentSince Dec 1, 2024 Accepting new patients

Locations

275 W Hospitality Ln
Ste 309
San Bernardino, CA 92408
Phone (951) 257-8045

41593 Winchester Rd
Ste 215
Temecula, CA 92590
Phone (951) 257-8045

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": "1508198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1093226029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2531 W WOODLAND DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012637",
            "telephone_number": "714-226-9888",
            "fax_number": "714-226-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2531 W WOODLAND DR",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928012637",
            "telephone_number": "714-226-9888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALENCIA",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL ANDREW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-17",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "117264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.