Individual provider Active NPI

Kenya Brown

  • Marriage & Family Therapist
  • Lake Elsinore, CA
National Provider Identifier
1487910196
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
31764 Casino Dr # 300
Lake Elsinore, CA 92530-2312
Phone
(951) 471-4645
Fax
(951) 471-4687
NPI assigned
Apr 6, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X CA Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

31764 Casino Dr # 300
Lake Elsinore, CA 92530-2312

Mailing address

PO Box 7549
Riverside, CA 92513-7549
Phone (951) 358-4600

Other practice location 1

2500 Wilshire Blvd
Suite 500
Los Angeles, CA 90057-4303
Phone (213) 639-0204

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

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1487910196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7549",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925137549",
            "telephone_number": "951-358-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31764 CASINO DR # 300",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925302312",
            "telephone_number": "951-471-4645",
            "fax_number": "951-471-4687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Wilshire Blvd",
            "address_2": "Suite 500",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900574303",
            "country_code": "US",
            "telephone_number": "213-639-0204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "KENYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-06",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2024; 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.