Active NPI
Debra Marie Kobold, LMFT # 106921
- Marriage & Family Therapist
- Brentwood, CA
National Provider Identifier
1174991640
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 106921
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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.