Active NPI
Kimberly Gengler, LMFT
- Marriage & Family Therapist
- San Rafael, CA
National Provider Identifier
1306470083
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 132419
- Practice address
- 1717 5TH Ave Unit C
San Rafael, CA 94901-1810 - Phone
- (415) 617-9436
- NPI assigned
- Mar 2, 2020
- 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 | 132419 | CA | Primary |
Addresses
Primary practice location
1717 5TH Ave Unit C
San Rafael, CA 94901-1810
Mailing address
22 Crestview Dr
San Rafael, CA 94903-2862
Phone (415) 794-0153
Other practice location 1
1303 San Carlos Ave
San Carlos, CA 94070-2317
Phone (650) 394-5155
Other practice location 2
76 San Pablo Ave
San Rafael, CA 94903-4179
Phone (831) 331-9202
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 132419 | Other | CA | BOARD OF BEHAVIORAL SCIENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 132419 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1754438400000",
"number": "1306470083",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 CRESTVIEW DR",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949032862",
"telephone_number": "415-794-0153"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 5TH AVE UNIT C",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949011810",
"telephone_number": "415-617-9436"
}
],
"practiceLocations": [
{
"address_1": "1303 San Carlos Ave",
"address_purpose": "LOCATION",
"city": "San Carlos",
"state": "CA",
"postal_code": "940702317",
"country_code": "US",
"telephone_number": "650-394-5155",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "76 San Pablo Ave",
"address_purpose": "LOCATION",
"city": "San Rafael",
"state": "CA",
"postal_code": "949034179",
"country_code": "US",
"telephone_number": "831-331-9202",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GENGLER",
"first_name": "KIMBERLY",
"credential": "LMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-02",
"last_updated": "2025-08-06",
"certification_date": "2025-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "132419",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF BEHAVIORAL SCIENCE",
"identifier": "132419",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.