Individual provider Active NPI

Kathryn Isabel Conklin, M.A., MFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1376897595
Registry record updated Nov 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC43175 Issued in CA
Practice address
4025 Camino del Rio S Ste 318
San Diego, CA 92108-4108
Phone
(619) 518-1784
NPI assigned
Nov 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 9, 2012

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 MFC43175 CA Primary

Addresses

Primary practice location

4025 Camino del Rio S Ste 318
San Diego, CA 92108-4108

Mailing address

4025 Camino del Rio S Ste 318
San Diego, CA 92108-4108
Phone (619) 518-1784

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
MFC43175CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1352419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352419200000",
    "number": "1376897595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 CAMINO DEL RIO S STE 318",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084108",
            "telephone_number": "619-518-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4025 CAMINO DEL RIO S STE 318",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921084108",
            "telephone_number": "619-518-1784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONKLIN",
        "first_name": "KATHRYN",
        "middle_name": "ISABEL",
        "name_prefix": "Ms.",
        "credential": "M.A., MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-09",
        "last_updated": "2012-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC43175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.