Kim Ruth Kupfer Meares, MFT

Individual provider Active NPI Marriage & Family Therapist · Lake Arrowhead, CA

NPI 1457574972 · NPPES record last updated Oct 22, 2018

Key facts

NPI
1457574972
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
MFC27299 (CA)
Practice address
27299 Hospital Road
Suite 107
Lake Arrowhead, CA 92352
Phone
(909) 383-7100
Fax
(909) 890-0244
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

Medicare Care Compare profile

Specialty
Marriage and Family Therapist
Education
Loma Linda University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Lake Arrowhead, CA 92352
Phone (909) 936-1742

PO Box
Suite 954
Lake Arrowhead, CA 92352-0954

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250422003598 CA Practitioner - Marriage and Family Therapist 1052836012 Practice locations: Lake Arrowhead, CA

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
MFC21299CAMDMarriage & Family Therapist
MFC27299CAMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC21299 CA
Marriage & Family Therapist 106H00000X MFC27299 CA Yes

Addresses

Primary practice location

27299 Hospital Road
Suite 107
Lake Arrowhead, CA 92352

Mailing address

PO Box 954
Lake Arrowhead, CA 92352
Phone (909) 383-7100

Other names

  • Mrs. Kim Ruth Kupfer Former name

Other providers in Lake Arrowhead, CA

All providers in Lake Arrowhead, CA · Marriage & Family Therapist in California

Sources for this page

Verify at the official NPI Registry.