Individual provider Active NPI

Kristin Chun, M.A., LMFT

  • Marriage & Family Therapist
  • San Francisco, CA
National Provider Identifier
1366511446
Registry record updated Mar 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
43946 Issued in CA
Practice address
3626 Balboa St
San Francisco, CA 94121-2604
Phone
(415) 668-5955
NPI assigned
Nov 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 43946 CA Primary
Mental Health Counselor 101YM0800X IMF39954 CA

Addresses

Primary practice location

3626 Balboa St
San Francisco, CA 94121-2604

Mailing address

651 Montezuma Dr
Pacifica, CA 94044-4028
Phone (650) 359-2386

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
IMF39954CAMDMental Health Counselor
43946CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584662400000",
    "number": "1366511446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "651 MONTEZUMA DR",
            "city": "PACIFICA",
            "state": "CA",
            "postal_code": "940444028",
            "telephone_number": "650-359-2386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3626 BALBOA ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941212604",
            "telephone_number": "415-668-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHUN",
        "first_name": "KRISTIN",
        "credential": "M.A., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-03-20",
        "certification_date": "2020-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "43946",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "IMF39954",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2020; 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.