Individual provider Active NPI

Debra Marie Kobold, LMFT # 106921

  • Marriage & Family Therapist
  • Brentwood, CA
National Provider Identifier
1174991640
Registry record updated Sep 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
106921 Issued in CA
Practice address
191 Sand Creek Rd Ste 215
Brentwood, CA 94513-2220
Phone
(925) 628-0501
Fax
(925) 464-1142
NPI assigned
Sep 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2018

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 106921 CA Primary

Addresses

Primary practice location

191 Sand Creek Rd Ste 215
Brentwood, CA 94513-2220

Mailing address

2631 Ranchwood Dr
Brentwood, CA 94513-5647
Phone (925) 628-0501

Other practice location 1

628 Montezuma St
Rio Vista, CA 94571-1622
Phone (707) 374-5243 ext. 26

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": "1442188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1174991640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2631 RANCHWOOD DR",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945135647",
            "telephone_number": "925-628-0501",
            "fax_number": "925-464-1142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 SAND CREEK RD STE 215",
            "city": "BRENTWOOD",
            "state": "CA",
            "postal_code": "945132220",
            "telephone_number": "925-628-0501",
            "fax_number": "925-464-1142"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "628 Montezuma St",
            "address_purpose": "LOCATION",
            "city": "Rio Vista",
            "state": "CA",
            "postal_code": "945711622",
            "country_code": "US",
            "telephone_number": "707-374-5243 x26",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOBOLD",
        "first_name": "DEBRA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LMFT # 106921",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-14",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "106921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brentwood, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.