Individual provider Active NPI

Kristen Marion Hendry

  • Marriage & Family Therapist
  • Venice, CA
National Provider Identifier
1336907468
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
140410 Issued in CA
Practice address
503 Ocean Front Walk
Venice, CA 90291-2403
Phone
(310) 392-3070
NPI assigned
Mar 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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 140410 CA Primary

Addresses

Primary practice location

503 Ocean Front Walk
Venice, CA 90291-2403

Mailing address

321 Market St
Venice, CA 90291-3732
Phone (813) 352-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Mar 30, 2026 through Mar 30, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
140410CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Houses of Los Angeles, Inc. PastSince Mar 17, 2024 Accepting new patients
Access Healing Counseling and Associates Marriage & Family Therapist Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1710201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1336907468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MARKET ST",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902913732",
            "telephone_number": "813-352-1054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 OCEAN FRONT WALK",
            "city": "VENICE",
            "state": "CA",
            "postal_code": "902912403",
            "telephone_number": "310-392-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENDRY",
        "first_name": "KRISTEN",
        "middle_name": "MARION",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-12",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "140410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Venice, CA

Sources for this page

Verify at the official NPI Registry.