Individual provider Active NPI

Kemisha Shiree Radford, PPS, LMFT

  • Marriage & Family Therapist
  • Manteca, CA
National Provider Identifier
1376082974
Registry record updated Aug 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
127682 Issued in CA
Practice address
302 Cherry LN Ste 208
Manteca, CA 95337-4311
Phone
(209) 647-6200
NPI assigned
Feb 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2026

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 127682 CA Primary

Addresses

Primary practice location

302 Cherry LN Ste 208
Manteca, CA 95337-4311

Mailing address

302 Cherry LN Ste 208
Manteca, CA 95337-4311
Phone (209) 647-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • 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
I20250521003182 CA Practitioner - Marriage and Family Therapist 0547789638 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127682CAMDClinical Social Worker
99107CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
County of San Joaquin CurrentSince Mar 14, 2025 Accepting new patients
San Joaquin Behavioral Health Services Marriage & Family Therapist Current Accepting new patients
San Joaquin County Public Health Services CurrentSince Mar 14, 2025 Accepting new patients

Locations

1209 W Tokay St
Ste 5
Lodi, CA 95240
Phone (209) 331-2070

1212 N California St
Stockton, CA 95202
Phone (209) 468-8660

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787616000000",
    "number": "1376082974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 208",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "209-647-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 CHERRY LN STE 208",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953374311",
            "telephone_number": "209-647-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADFORD",
        "first_name": "KEMISHA",
        "middle_name": "SHIREE",
        "name_prefix": "Ms.",
        "credential": "PPS, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-15",
        "last_updated": "2026-08-25",
        "certification_date": "2026-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "127682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manteca, CA

Sources for this page

Verify at the official NPI Registry.