Active NPI
Kendra Theroith
- Marriage & Family Therapist
- Riverside, CA
National Provider Identifier
1134401672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 99414
- Practice address
- 2085 Rustin Ave # 4
Riverside, CA 92507-2498 - Phone
- (951) 955-8000
- NPI assigned
- Sep 11, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 99414 | CA | Primary |
Addresses
Primary practice location
2085 Rustin Ave # 4
Riverside, CA 92507-2498
Mailing address
9431 Haven Ave Ste 100
Rancho Cucamonga, CA 91730-5879
Phone (909) 282-2610
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
| License | State | Type | Specialty |
|---|---|---|---|
| 99414 | CA | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Midwest Counseling and Family Services Inc. | Current | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1134401672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9431 HAVEN AVE STE 100",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917305879",
"telephone_number": "909-282-2610"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2085 RUSTIN AVE # 4",
"city": "RIVERSIDE",
"state": "CA",
"postal_code": "925072498",
"telephone_number": "951-955-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THEROITH",
"first_name": "KENDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-09-11",
"last_updated": "2023-03-07",
"certification_date": "2023-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "99414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Riverside, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.