Individual provider Active NPI

Renate Dorothea Kerris, MA MFT

  • Marriage & Family Therapist
  • Monrovia, CA
National Provider Identifier
1114122264
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC36586 Issued in CA
Practice address
248 East Foothill Blvd
Ste 100
Monrovia, CA 91016
Phone
(626) 358-0155
Fax
(626) 793-9921
NPI assigned
Jun 19, 2007
Sex
Female
Sole proprietor
No

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 MFC36586 CA Primary

Addresses

Primary practice location

248 East Foothill Blvd
Ste 100
Monrovia, CA 91016

Mailing address

248 East Foothill Blvd
Ste 100
Monrovia, CA 91016
Phone (626) 358-0155

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC36586CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1182211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114122264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 EAST FOOTHILL BLVD",
            "address_2": "STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "91016",
            "telephone_number": "626-358-0155",
            "fax_number": "626-793-9921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 EAST FOOTHILL BLVD",
            "address_2": "STE 100",
            "city": "MONROVIA",
            "state": "CA",
            "postal_code": "91016",
            "telephone_number": "626-358-0155",
            "fax_number": "626-793-9921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KERRIS",
        "first_name": "RENATE",
        "middle_name": "DOROTHEA",
        "name_prefix": "Ms.",
        "credential": "MA MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC36586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monrovia, 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.