Individual provider Active NPI

Stacy Knox, AMFT120724

  • Marriage & Family Therapist
  • Eureka, CA
National Provider Identifier
1104212257
Registry record updated Aug 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
154787 Issued in CA
Practice address
2350 Buhne St
Eureka, CA 95501-3238
Phone
(707) 443-4593
Fax
(707) 269-7116
NPI assigned
Apr 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2026

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 154787 CA Primary

Addresses

Primary practice location

2350 Buhne St
Eureka, CA 95501-3238

Mailing address

2350 Buhne St
Eureka, CA 95501-3238
Phone (707) 443-4593

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
I20260608001064 CA Practitioner - Marriage and Family Therapist 3274004510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10113 Cooper Lake Ave
Bakersfield, CA 93311-4700

1220 Diamond Way
Suite 240
Concord, CA 94520-5260

6538 Jade CT
Eastvale, CA 92880-8551

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6306-RCAMDAddiction (Substance Use Disorder) Counselor
154787CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Kern Bridges Youth Homes, Inc. CurrentSince Dec 6, 2020 Accepting new patients

Locations

1321 Stine Rd
Bakersfield, CA 93309
Phone (661) 396-2301

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787961600000",
    "number": "1104212257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 BUHNE ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013238",
            "telephone_number": "707-443-4593",
            "fax_number": "707-269-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 BUHNE ST",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013238",
            "telephone_number": "707-443-4593",
            "fax_number": "707-269-7116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOX",
        "first_name": "STACY",
        "credential": "AMFT120724",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2026-08-29",
        "certification_date": "2026-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "154787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eureka, CA

Sources for this page

Verify at the official NPI Registry.