Individual provider Active NPI

Khristine M Anthony

  • Marriage & Family Therapist
  • Murrieta, CA
National Provider Identifier
1396391330
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110928 Issued in CA
Practice address
30755 Auld Rd
Murrieta, CA 92563-2599
Phone
(951) 696-3114
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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 110928 CA Primary

Addresses

Primary practice location

30755 Auld Rd
Murrieta, CA 92563-2599

Mailing address

30755 Auld Rd
Murrieta, CA 92563-2599
Phone (951) 696-3114

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
I20241008000359 CA Practitioner - Marriage and Family Therapist 5092246603 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
127392CAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Aug 4, 2024 Accepting new patients

Locations

99 Almaden Blvd
Ste 600
San Jose, CA 95113
Phone (408) 402-4385

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1396391330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30755 AULD RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632599",
            "telephone_number": "951-696-3114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30755 AULD RD",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925632599",
            "telephone_number": "951-696-3114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "KHRISTINE",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murrieta, CA

Sources for this page

Verify at the official NPI Registry.