Individual provider Active NPI

Kelly Lundquist, AMFT

  • Marriage & Family Therapist
  • Newport Beach, CA
National Provider Identifier
1346124872
Registry record updated Aug 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
AMFT129177 Issued in CA
Practice address
4060 Campus Dr Ste 120
Newport Beach, CA 92660-2205
Phone
(714) 497-3008
NPI assigned
Aug 5, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2025

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 AMFT129177 CA Primary

Addresses

Primary practice location

4060 Campus Dr Ste 120
Newport Beach, CA 92660-2205

Mailing address

4060 Campus Dr Ste 120
Newport Beach, CA 92660-2205

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
AMFT129177CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754352000000",
    "number": "1346124872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 CAMPUS DR STE 120",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602205",
            "telephone_number": "714-497-3008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDQUIST",
        "first_name": "KELLY",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-08-05",
        "certification_date": "2025-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT129177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.