Active NPI
Kayla Masterson
- Mental Health Counselor
- Sutter Creek, CA
National Provider Identifier
1376018457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 10877 Conductor Blvd
Sutter Creek, CA 95685-9687 - Phone
- (209) 223-6412
- NPI assigned
- Oct 4, 2018
- Last updated
- Dec 17, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | NU | Primary | |
| Mental Health Counselor | 101YM0800X | 14236 | CA |
Addresses
Primary practice location
10877 Conductor Blvd
Sutter Creek, CA 95685-9687
Mailing address
258 Flower Dr
Folsom, CA 95630-2747
Phone (916) 220-6696
Other practice location 1
3650 Auburn Blvd
Sacramento, CA 95821-2069
Phone (916) 300-6576
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
| License | State | Type | Specialty |
|---|---|---|---|
| 14236 | CA | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Amador | Past | Accepting new patients | |
| County of Amador | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Sutter Creek, CA
- NPI 1205055886
-
dba Amador County Behavioral Health SUD
- Substance Use Disorder Rehabilitation Clinic/Center
- Sutter Creek, CA
- NPI 1699321752
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1538611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702771200000",
"number": "1376018457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 FLOWER DR",
"city": "FOLSOM",
"state": "CA",
"postal_code": "956302747",
"telephone_number": "916-220-6696"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10877 CONDUCTOR BLVD",
"city": "SUTTER CREEK",
"state": "CA",
"postal_code": "956859687",
"telephone_number": "209-223-6412"
}
],
"practiceLocations": [
{
"address_1": "3650 Auburn Blvd",
"address_purpose": "LOCATION",
"city": "Sacramento",
"state": "CA",
"postal_code": "958212069",
"country_code": "US",
"telephone_number": "916-300-6576",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MASTERSON",
"first_name": "KAYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-04",
"last_updated": "2023-12-17",
"certification_date": "2023-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "14236",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sutter Creek, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.