Individual provider Active NPI

Kerreen Chau, IMF

  • Marriage & Family Therapist
  • San Clemente, CA
National Provider Identifier
1114056850
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT46122 Issued in CA
Practice address
101 S El Camino Real Ste 106
San Clemente, CA 92672-5504
Phone
(949) 769-0153
Fax
(619) 378-7973
NPI assigned
Mar 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2024

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 LMFT46122 CA Primary

Addresses

Primary practice location

101 S El Camino Real Ste 106
San Clemente, CA 92672-5504

Mailing address

101 S El Camino Real Ste 106
San Clemente, CA 92672-5504
Phone (949) 769-0153

Other practice location 1

1401 N El Camino Real Ste 100
San Clemente, CA 92672-4983
Phone (858) 522-0145

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
I20240307003694 CA Practitioner - Marriage and Family Therapist 6406292820 Reassigns benefits to 1 organization

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
Telehealth
Offers telehealth services
Group practices
Brittany Watson NP Nursing CorporationGroup PAC ID 9335592211, 7 clinicians

Practice addresses (Care Compare)

1401 N El Camino Real
Suite 100
San Clemente, CA 92672-4983
Phone (858) 522-0145

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT46122CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Brittany Watson NP Nursing Corporation Marriage & Family Therapist CurrentSince Jan 1, 2024 Accepting new patients
Oc Couple and Family Therapy CurrentSince May 26, 2024 Accepting new patients

Locations

1401 N El Camino Real
Ste 100
San Clemente, CA 92672
Phone (858) 522-0145

101 S El Camino Real
Ste 106
San Clemente, CA 92672
Phone (858) 522-0145

4420 Hotel Circle Ct
Ste 200
San Diego, CA 92108
Phone (619) 933-2165

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": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1114056850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S EL CAMINO REAL STE 106",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725504",
            "telephone_number": "949-769-0153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 S EL CAMINO REAL STE 106",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926725504",
            "telephone_number": "949-769-0153",
            "fax_number": "619-378-7973"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1401 N El Camino Real Ste 100",
            "address_purpose": "LOCATION",
            "city": "San Clemente",
            "state": "CA",
            "postal_code": "926724983",
            "country_code": "US",
            "telephone_number": "858-522-0145",
            "fax_number": "619-378-7973",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHAU",
        "first_name": "KERREEN",
        "name_prefix": "Ms.",
        "credential": "IMF",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-05",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT46122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

Verify at the official NPI Registry.