Individual provider Active NPI

Kandice Nadene Marshall-Cunanan, LMFT

  • Marriage & Family Therapist
  • Redondo Beach, CA
National Provider Identifier
1114222387
Registry record updated Dec 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
94154 Issued in CA
Practice address
901 N Pacific Coast Hwy
Redondo Beach, CA 90277-2162
Phone
(310) 316-1640
Fax
(310) 316-4209
NPI assigned
Jan 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 16, 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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 106H00000X 94154 CA Primary

Addresses

Primary practice location

901 N Pacific Coast Hwy
Redondo Beach, CA 90277-2162

Mailing address

516 Pennsfield PL Ste 212
Thousand Oaks, CA 91360-5575
Phone (805) 558-5451

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

State licenses

LicenseStateTypeSpecialty
94154CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1114222387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 PENNSFIELD PL STE 212",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605575",
            "telephone_number": "805-558-5451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N PACIFIC COAST HWY",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902772162",
            "telephone_number": "310-316-1640",
            "fax_number": "310-316-4209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARSHALL-CUNANAN",
        "first_name": "KANDICE",
        "middle_name": "NADENE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-20",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "94154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.