Individual provider Active NPI

Kelly Jean Lowry, LMFT

  • Marriage & Family Therapist
  • Antioch, CA
National Provider Identifier
1174729610
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT47486 Issued in CA
Practice address
2225 Buchanan Rd Ste C
Antioch, CA 94509-4209
Phone
(925) 726-5594
Fax
(925) 706-1283
NPI assigned
Jun 22, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 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 LMFT47486 CA Primary

Addresses

Primary practice location

2225 Buchanan Rd Ste C
Antioch, CA 94509-4209

Mailing address

2225 Buchanan Rd Ste C
Antioch, CA 94509-4209
Phone (925) 726-5594

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
I20240212000351 CA Practitioner - Marriage and Family Therapist 6406299098 Practice locations: Antioch, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2225 Buchanan Rd
Suite C
Antioch, CA 94509-4209
Phone (925) 726-5594

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT47486CAMDMarriage & Family Therapist
47486CAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1182470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1174729610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 BUCHANAN RD STE C",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094209",
            "telephone_number": "925-726-5594",
            "fax_number": "925-706-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 BUCHANAN RD STE C",
            "city": "ANTIOCH",
            "state": "CA",
            "postal_code": "945094209",
            "telephone_number": "925-726-5594",
            "fax_number": "925-706-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOWRY",
        "first_name": "KELLY",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-22",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT47486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, CA

Sources for this page

Verify at the official NPI Registry.