Individual provider Active NPI

Cynthia Lynn Wolfrom, LMFT 124584

  • Marriage & Family Therapist
  • Redding, CA
National Provider Identifier
1235644824
Registry record updated Jan 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT124584 Issued in CA
Practice address
1411 Yuba St
Redding, CA 96001-1010
Phone
(530) 225-5364
NPI assigned
Dec 5, 2017
Last updated
Jan 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2023

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 LMFT124584 CA Primary

Addresses

Primary practice location

1411 Yuba St
Redding, CA 96001-1010

Mailing address

19343 Titleist Way
Redding, CA 96003-8627
Phone (530) 332-0690

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
I20250819002516 CA Practitioner - Marriage and Family Therapist 2567961220 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

5201 Great America Pkwy
Suite 320
Santa Clara, CA 95054-1140
Phone (323) 968-6182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT124584CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Aug 4, 2025 Accepting new patients
County of Shasta Past Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1512432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674950400000",
    "number": "1235644824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19343 TITLEIST WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960038627",
            "telephone_number": "530-332-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 YUBA ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011010",
            "telephone_number": "530-225-5364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLFROM",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "credential": "LMFT 124584",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-05",
        "last_updated": "2023-01-29",
        "certification_date": "2023-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT124584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

Verify at the official NPI Registry.