Individual provider Active NPI

Kristel Roper, LMFT, LPCC

  • Marriage & Family Therapist
  • Fair Oaks, CA
National Provider Identifier
1366825663
Registry record updated Oct 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT107976 Issued in CA
Practice address
9821 Fair Oaks Blvd Ste B
Fair Oaks, CA 95628-7050
Phone
(530) 424-8636
NPI assigned
Jul 4, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPCC6649 CA
Marriage & Family Therapist 106H00000X LMFT107976 CA Primary

Addresses

Primary practice location

9821 Fair Oaks Blvd Ste B
Fair Oaks, CA 95628-7050

Mailing address

9821 Fair Oaks Blvd Ste B
Fair Oaks, CA 95628-7050
Phone (530) 424-8636

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
Green means eligible to order or refer.
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

LicenseStateTypeSpecialty
LPCC6649CAMDMental Health Counselor
107976CAMDClinical Social Worker
LMFT107976CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1435968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1366825663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9821 FAIR OAKS BLVD STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287050",
            "telephone_number": "530-424-8636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9821 FAIR OAKS BLVD STE B",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287050",
            "telephone_number": "530-424-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROPER",
        "first_name": "KRISTEL",
        "name_prefix": "Miss",
        "credential": "LMFT, LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-04",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "LPCC6649",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT107976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

Verify at the official NPI Registry.