Individual provider Active NPI

Kimberly Lauren Koljat, LMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1144652876
Registry record updated Apr 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
91272 Issued in CA
Practice address
1426 Fillmore St Ste 216
San Francisco, CA 94115-4164
Phone
(415) 379-0945
NPI assigned
Aug 5, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Marriage & Family Therapist 106H00000X 91272 CA Primary

Addresses

Primary practice location

1426 Fillmore St Ste 216
San Francisco, CA 94115-4164

Mailing address

1426 Fillmore St Ste 216
San Francisco, CA 94115-4164
Phone (415) 379-0945

Other practice location 1

1 Saint Vincents Dr
San Rafael, CA 94903-1504
Phone (415) 507-4389

Other practice location 2

1 Saint Vincents Dr
San Rafael, CA 94903-1504
Phone (415) 507-4389

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

NPI Registry JSON

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

{
    "created_epoch": "1375660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524182400000",
    "number": "1144652876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1426 FILLMORE ST STE 216",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941154164",
            "telephone_number": "415-379-0945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1426 FILLMORE ST STE 216",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941154164",
            "telephone_number": "415-379-0945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Saint Vincents Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949031504",
            "country_code": "US",
            "telephone_number": "415-507-4389",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Saint Vincents Dr",
            "address_purpose": "LOCATION",
            "city": "San Rafael",
            "state": "CA",
            "postal_code": "949031504",
            "country_code": "US",
            "telephone_number": "415-507-4389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLJAT",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-05",
        "last_updated": "2018-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "91272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2018; 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.