Individual provider Active NPI

Kathryn Denine Krug, LMFT

  • Marriage & Family Therapist
  • Santee, CA
National Provider Identifier
1487283263
Registry record updated Apr 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
110356 Issued in CA
Practice address
10800 Woodside Ave
Santee, CA 92071-3137
Phone
(619) 353-0818
NPI assigned
Apr 3, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2020

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 110356 CA Primary

Addresses

Primary practice location

10800 Woodside Ave
Santee, CA 92071-3137

Mailing address

PO Box 711742
Santee, CA 92072-1742
Phone (858) 342-0501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20231216000024 TX Practitioner - Marriage and Family Therapist 9830409325 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southern Indian Health Council 18 clinicians

Practice addresses (Care Compare)

36350 Church Rd
Campo, CA 91906-2715
Phone (619) 445-1188

4058 Willows Rd
Alpine, CA 91901-1668

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110356CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Krug and Park Family Counseling PC Marriage & Family Therapist CurrentSince Dec 16, 2020 Accepting new patients
Southern Indian Health Council CurrentSince Jan 1, 2024 Accepting new patients
Southern Indian Health Council CurrentSince Jan 1, 2024 Accepting new patients
Southern Indian Health Council Past Accepting new patients
Southern Indian Health Council Past Accepting new patients

Locations

5001 Willows Rd
Ste J111
Alpine, CA 91901
Phone (619) 445-1188

4058 Willows Rd
Alpine, CA 91901
Phone (619) 445-1188

36350 Church Rd
Campo, CA 91906
Phone (619) 445-1188

5360 Jackson Dr
Ste 220C
La Mesa, CA 91942
Phone (619) 353-0818

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1585872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585872000000",
    "number": "1487283263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711742",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920721742",
            "telephone_number": "858-342-0501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 WOODSIDE AVE",
            "city": "SANTEE",
            "state": "CA",
            "postal_code": "920713137",
            "telephone_number": "619-353-0818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRUG",
        "first_name": "KATHRYN",
        "middle_name": "DENINE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-03",
        "last_updated": "2020-04-03",
        "certification_date": "2020-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "110356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santee, CA

Sources for this page

Verify at the official NPI Registry.