Kathleen Joan Fox, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

IMF96904 Issued in CA

Practice address

1800 N. Gravenstein Hwy
Sebastopol, CA 95472

Phone

(707) 634-9075

NPI assigned

Aug 24, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathleen Joan O'Brien Fox Other name

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• TLC Child & Family Services

  • Adolescent and Children Mental Health Clinic/Center
  • Sebastopol, CA
  • NPI 1073131942
  NPD (past)

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583798400000",
    "number": "1316428592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 N. GRAVENSTEIN HWY",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 N. GRAVENSTEIN HWY",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "95472",
            "telephone_number": "707-634-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "KATHLEEN",
        "middle_name": "JOAN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2020-03-10",
        "certification_date": "2020-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF96904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "FOX",
            "middle_name": "JOAN O'BRIEN",
            "credential": "MA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• John Forman, PHARMD
• Heather R. Foster, MA, LMFT
• Lauren Foster
• Marilyn W Foster, FNP
• Dana Fox, L.M.
• Jen Lynn Foye, MA, LMFT
• Anna Vittoria Frattolillo, AMFT 92158
• Toby Ellen French, MFT
• Jennifer Frendo, M.S. CCC-SLP
• David Fromm, M.D.

• Marriage & Family Therapist in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.