Individual provider Active NPI

Patricia Kolberg, LMFT

  • Marriage & Family Therapist
  • Diamond Springs, CA
National Provider Identifier
1114091683
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
33032 Issued in CA
Practice address
550 Main St Ste 1D
Diamond Springs, CA 95619-9177
Phone
(530) 647-2684
NPI assigned
Nov 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 33032 CA Primary

Addresses

Primary practice location

550 Main St Ste 1D
Diamond Springs, CA 95619-9177

Mailing address

1600 Dashing Ranch Rd
Placerville, CA 95667-7662
Phone (530) 647-2909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114091683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 DASHING RANCH RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956677662",
            "telephone_number": "530-647-2909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MAIN ST STE 1D",
            "city": "DIAMOND SPRINGS",
            "state": "CA",
            "postal_code": "956199177",
            "telephone_number": "530-647-2684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLBERG",
        "first_name": "PATRICIA",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "33032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Diamond Springs, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.