Individual provider Active NPI

Kiran Haynes, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
National Provider Identifier
1215393665
Registry record updated Jun 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT121216 Issued in CA
Practice address
70 Glendora Ave Apt 3
Long Beach, CA 90803-3441
Phone
(626) 664-9818
NPI assigned
Jan 14, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X AMFT101220 CA
Marriage & Family Therapist 106H00000X LMFT121216 CA Primary

Addresses

Primary practice location

70 Glendora Ave Apt 3
Long Beach, CA 90803-3441

Mailing address

70 Glendora Ave Apt 3
Long Beach, CA 90803-3441
Phone (626) 664-9818

Other practice location 1

2502 E. Huntington Dr.
Duarte, CA 91010
Phone (626) 280-6510

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
I20240229002590 CA Practitioner - Marriage and Family Therapist 0042655052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sokyahealth Medical Group PCGroup PAC ID 8628463015, 180 clinicians

Practice addresses (Care Compare)

5060 Shoreham PL
Suite 330
San Diego, CA 92122-5976
Phone (858) 427-5060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
121216CAMDClinical Social Worker
AMFT101220CAMDMarriage & Family Therapist
LMFT121216CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sokyahealth Medical Group PC Marriage & Family Therapist CurrentSince Feb 16, 2024 Accepting new patients

Locations

2386 Faraday Ave
Ste 110
Carlsbad, CA 92008
Phone (858) 427-5060

5060 Shoreham Pl
Ste 330
San Diego, CA 92122
Phone (619) 866-0998

Interoperability endpoints

  • Direct secure messaging: kiran.haynes.p1@direct.sokya.nextgenshare.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654041600000",
    "number": "1215393665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 GLENDORA AVE APT 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033441",
            "telephone_number": "626-664-9818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 GLENDORA AVE APT 3",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908033441",
            "telephone_number": "626-664-9818"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2502 E. Huntington Dr.",
            "address_purpose": "LOCATION",
            "city": "Duarte",
            "state": "CA",
            "postal_code": "91010",
            "country_code": "US",
            "telephone_number": "626-280-6510",
            "fax_number": "626-288-8903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYNES",
        "first_name": "KIRAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-01-14",
        "last_updated": "2022-06-01",
        "certification_date": "2022-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT101220",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT121216",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

Verify at the official NPI Registry.