Individual provider Active NPI

Kaci Lynn Hailstone, MA, AMFT

  • Marriage & Family Therapist
  • Brea, CA
National Provider Identifier
1154735124
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
142293 Issued in CA
Practice address
265 S Randolph Ave Ste 100
Brea, CA 92821-5791
Phone
(657) 201-7949
NPI assigned
Jun 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 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 Therapist 106H00000X 142293 CA Primary

Addresses

Primary practice location

265 S Randolph Ave Ste 100
Brea, CA 92821-5791

Mailing address

265 S Randolph Ave Ste 250
Brea, CA 92821-5701

Other names 1

  • Kaci Lynn Thomas Former name

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
142293CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1154735124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 250",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 100",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215791",
            "telephone_number": "657-201-7949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAILSTONE",
        "first_name": "KACI",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "MA, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-17",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACI",
            "last_name": "THOMAS",
            "middle_name": "LYNN",
            "credential": "MA, AMFT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.