Individual provider Active NPI

Khaila Zherine Flores

  • Mental Health Counselor
  • Vallejo, CA
National Provider Identifier
1134793250
Registry record updated May 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
8166 Issued in CA
Practice address
1731 Tuolumne St
Vallejo, CA 94589-2618
Phone
(415) 535-2224
NPI assigned
May 13, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 8166 CA Primary

Addresses

Primary practice location

1731 Tuolumne St
Vallejo, CA 94589-2618

Mailing address

1731 Tuolumne St
Vallejo, CA 94589-2618
Phone (415) 535-2224

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
I20260225004252 CA Practitioner - Marriage and Family Therapist 8729569942 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1731 Tuolumne St
Vallejo, CA 94589-2618

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19429CAMDAddiction (Substance Use Disorder) Counselor
8166CAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca CurrentSince Feb 10, 2026 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

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.

NPI Registry JSON

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620864000000",
    "number": "1134793250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892618",
            "telephone_number": "415-535-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 TUOLUMNE ST",
            "city": "VALLEJO",
            "state": "CA",
            "postal_code": "945892618",
            "telephone_number": "415-535-2224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLORES",
        "first_name": "KHAILA ZHERINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-05-13",
        "certification_date": "2021-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "8166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vallejo, CA

Sources for this page

Verify at the official NPI Registry.