Kris Coffman

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT104301 Issued in CA

Practice address

3300 Broadway Ste 502
Eureka, CA 95501-3812

Phone

(707) 440-9299

NPI assigned

Apr 17, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 11, 2024 through Feb 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Earth Family Therapy

  • Group Psychotherapy Psychologist
  • Eureka, CA
  • NPI 1356230080
  NPD Authorized official

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

{
    "created_epoch": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670284800000",
    "number": "1508353483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 BROADWAY STE 502",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013812",
            "telephone_number": "707-440-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 BROADWAY STE 502",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955013812",
            "telephone_number": "707-440-9299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Stone Blvd Ste 175",
            "address_purpose": "LOCATION",
            "city": "West Sacramento",
            "state": "CA",
            "postal_code": "956914055",
            "country_code": "US",
            "telephone_number": "916-425-7733",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24077 CA-49",
            "address_purpose": "LOCATION",
            "city": "Nevada City",
            "state": "CA",
            "postal_code": "95959",
            "country_code": "US",
            "telephone_number": "530-265-9057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COFFMAN",
        "first_name": "KRIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT131324",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT104301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Notes",
            "affiliation": "N",
            "address_1": "3300 Broadway Ste 502",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955013812",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica C Coats
• Randolph Coats, LMFT
• Luther F Cobb, M.D.
• Terry L Coddington, CATC
• Christopher Lee Cody, MD
• Jacqueline Renee Coghill
• Jenner Cohune, MFTI
• Aharin Coke
• Blake Nicole Coke, M.F.T.I.
• Chelsea Judith Colby, LAC

• Marriage & Family Therapist in Eureka, CA
• Providers in Eureka, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.