Individual provider Active NPI

Kristen Ackerman, MFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1225410137
Registry record updated Aug 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
114822 Issued in CA
Practice address
3065 Rosecrans PL Ste 202
San Diego, CA 92110-4822
Phone
(619) 333-6139
NPI assigned
Jun 26, 2015
Last updated
Aug 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2026

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 IMF95866 CA
Marriage & Family Therapist 106H00000X 114822 CA Primary

Addresses

Primary practice location

3065 Rosecrans PL Ste 202
San Diego, CA 92110-4822

Mailing address

3065 Rosecrans PL Ste 202
San Diego, CA 92110-4822
Phone (619) 333-6139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 8, 2026 through Jul 8, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
114822CAMDMarriage & Family Therapist
IMF95866CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785628800000",
    "number": "1225410137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3065 ROSECRANS PL STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104822",
            "telephone_number": "619-333-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3065 ROSECRANS PL STE 202",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921104822",
            "telephone_number": "619-333-6139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ACKERMAN",
        "first_name": "KRISTEN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-26",
        "last_updated": "2026-08-02",
        "certification_date": "2026-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF95866",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "114822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.