Individual provider Active NPI

Kimberly Renee Barnes, MFT-I

  • Marriage & Family Therapist
  • South Lake Tahoe, CA
National Provider Identifier
1386095495
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
71952 Issued in CA
Practice address
1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305
Phone
(530) 573-7970
Fax
(530) 543-6873
NPI assigned
Jun 29, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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 71952 CA Primary

Addresses

Primary practice location

1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305

Mailing address

1900 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-6305
Phone (530) 573-7970

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

LicenseStateTypeSpecialty
71952CAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1467158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1386095495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 LAKE TAHOE BLVD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506305",
            "telephone_number": "530-573-7970",
            "fax_number": "530-543-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 LAKE TAHOE BLVD",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961506305",
            "telephone_number": "530-573-7970",
            "fax_number": "530-543-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARNES",
        "first_name": "KIMBERLY",
        "middle_name": "RENEE",
        "credential": "MFT-I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "71952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lake Tahoe, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.