Individual provider Active NPI

Kelly Dawn Thompson

  • Marriage & Family Therapist
  • Temecula, CA
National Provider Identifier
1376067231
Registry record updated Mar 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
152301 Issued in CA
Practice address
28693 Old Town Front St
Temecula, CA 92590-2786
Phone
(951) 395-1916
NPI assigned
Aug 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 31, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 205935 TX
Case Manager/Care Coordinator 171M00000X
Clinical Social Worker 1041C0700X AMFT126507 CA
Marriage & Family Therapist 106H00000X 152301 CA Primary

Addresses

Primary practice location

28693 Old Town Front St
Temecula, CA 92590-2786

Mailing address

3470 Nature Trail CT
Perris, CA 92571-7364
Phone (661) 345-0036

Other practice location 1

9990 County Farm Rd Ste 5
Riverside, CA 92503-3542
Phone (951) 374-3516 ext. 83399

Other practice location 2

1370 S State St Ste A
San Jacinto, CA 92583-4922
Phone (951) 791-3330

Other practice location 3

1627 S Hargrave St
Banning, CA 92220-6169
Phone (951) 922-7300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250325001057 CA Practitioner - Marriage and Family Therapist 6507389137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AMFT126507CAMDClinical Social Worker
152301CAMDMarriage & Family Therapist
205935TXMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flourish Family Counseling, Inc. Marriage & Family Therapist CurrentSince Mar 13, 2025 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1501545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774915200000",
    "number": "1376067231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3470 NATURE TRAIL CT",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925717364",
            "telephone_number": "661-345-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28693 OLD TOWN FRONT ST",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902786",
            "telephone_number": "951-395-1916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9990 County Farm Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925033542",
            "country_code": "US",
            "telephone_number": "951-374-3516 x83399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1370 S State St Ste A",
            "address_purpose": "LOCATION",
            "city": "San Jacinto",
            "state": "CA",
            "postal_code": "925834922",
            "country_code": "US",
            "telephone_number": "951-791-3330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1627 S Hargrave St",
            "address_purpose": "LOCATION",
            "city": "Banning",
            "state": "CA",
            "postal_code": "922206169",
            "country_code": "US",
            "telephone_number": "951-922-7300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "KELLY",
        "middle_name": "DAWN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-01",
        "last_updated": "2026-03-31",
        "certification_date": "2026-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "205935",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "AMFT126507",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "152301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

Verify at the official NPI Registry.