Chandra Kristine Bomben, MFTI

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

11768 Atwood Rd Ste 106
Auburn, CA 95603-9005

Phone

(530) 314-9771

NPI assigned

Jun 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Forward Wellness Family Therapy, Inc.

  • Community/Behavioral Health Agency
  • Placentia, CA
  • NPI 1093398059
  Medicare reassignment NPD

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

{
    "created_epoch": "1182384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677196800000",
    "number": "1144426859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 AGARD ST",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956035102",
            "telephone_number": "530-314-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11768 ATWOOD RD STE 106",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956039005",
            "telephone_number": "530-314-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBEN",
        "first_name": "CHANDRA",
        "middle_name": "KRISTINE",
        "name_prefix": "Ms.",
        "credential": "MFTI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-21",
        "last_updated": "2023-02-24",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": "RAS",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MARRIAGE AND FAMILY THERAPIST",
            "identifier": "112196",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy S. Bloom, LCSW
• Laura Boal
• Jennifer Kay Boes, LCSW
• Elizabeth Gomes Boettner, M.S.P.T.
• Alister Bohegian
• Christine Bonacci, M.D.
• Jennifer Marie Booth
• Saren Borden, RADT
• Chris Boseovski, MD
• Pamela Boss

• Marriage & Family Therapist in Auburn, CA
• Providers in Auburn, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.