Active NPI
Keumboon Katherine Kwon, MFT
- Marriage & Family Therapist
- Van Nuys, CA
National Provider Identifier
1376668939
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF46288
- Practice address
- 5900 Sepulveda Blvd Ste 425
Van Nuys, CA 91411-2526 - Phone
- (818) 267-1100
- Fax
- (818) 267-1199
- NPI assigned
- Mar 20, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | IMF46288 | CA | Primary |
Addresses
Primary practice location
5900 Sepulveda Blvd Ste 425
Van Nuys, CA 91411-2526
Mailing address
5900 Sepulveda Blvd Ste 425
Van Nuys, CA 91411-2526
Phone (818) 267-1100
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 |
|---|---|---|---|
| IMF46288 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pacific Clinics | Past | 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 and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- Ontario, CA
- NPI 1902273923
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174348800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192233600000",
"number": "1376668939",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5900 SEPULVEDA BLVD STE 425",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914112526",
"telephone_number": "818-267-1100",
"fax_number": "818-267-1199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5900 SEPULVEDA BLVD STE 425",
"city": "VAN NUYS",
"state": "CA",
"postal_code": "914112526",
"telephone_number": "818-267-1100",
"fax_number": "818-267-1199"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KWON",
"first_name": "KEUMBOON",
"middle_name": "KATHERINE",
"credential": "MFT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-20",
"last_updated": "2007-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF46288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Van Nuys, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.