Active NPI
Kent Edward Kodama
- Marriage & Family Therapist
- Covina, CA
National Provider Identifier
1427560549
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 132831
- Practice address
- 17727 E Cypress St
Covina, CA 91722-2634 - Phone
- (626) 858-4921
- NPI assigned
- Oct 30, 2017
- Last updated
- Oct 1, 2025
- Sex
- Male
- Sole proprietor
- Yes
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 | 132831 | CA | Primary |
Addresses
Primary practice location
17727 E Cypress St
Covina, CA 91722-2634
Mailing address
17727 E Cypress St
Covina, CA 91722-2634
Phone (626) 858-4921
Other practice location 1
508 S 2nd Ave
Covina, CA 91723-3012
Phone (626) 974-8123
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 |
|---|---|---|---|
| 132831 | CA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Los Angeles County Department of Public Health | Current | Accepting new patients | |
| Social Model Recovery Systems, Inc. | Past | Accepting new patients | |
| Social Model Recovery Systems, Inc. | Past | Accepting new patients |
Interoperability endpoints
- kentkodama-socialmodel@lacsapc.netsmartdirect.net
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Public Health or Welfare Agency
- Alhambra, CA
- NPI 1700090834
-
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1497834089
-
dba River Community Covina
- Community/Behavioral Health Agency
- Covina, CA
- NPI 1508994369
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1759276800000",
"number": "1427560549",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17727 E CYPRESS ST",
"city": "COVINA",
"state": "CA",
"postal_code": "917222634",
"telephone_number": "626-858-4921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17727 E CYPRESS ST",
"city": "COVINA",
"state": "CA",
"postal_code": "917222634",
"telephone_number": "626-858-4921"
}
],
"practiceLocations": [
{
"address_1": "508 S 2nd Ave",
"address_purpose": "LOCATION",
"city": "Covina",
"state": "CA",
"postal_code": "917233012",
"country_code": "US",
"telephone_number": "626-974-8123",
"fax_number": "626-974-8198",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KODAMA",
"first_name": "KENT",
"middle_name": "EDWARD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-10-30",
"last_updated": "2025-10-01",
"certification_date": "2025-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "132831",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Covina, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.