Keith Parley Kilburn, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC32587 Issued in CA

Practice address

25 Western Av
Petaluma, CA 94952

Phone

(707) 526-8306

Fax

(707) 776-0935

NPI assigned

Sep 16, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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• Sud Specialty Group - Ca

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  • Addiction Medicine (Psychiatry & Neurology) Physician
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  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518063494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 SKILLMAN LN",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-762-4338",
            "fax_number": "707-776-0935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 WESTERN AV",
            "city": "PETALUMA",
            "state": "CA",
            "postal_code": "94952",
            "telephone_number": "707-526-8306",
            "fax_number": "707-776-0935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBURN",
        "first_name": "KEITH",
        "middle_name": "PARLEY",
        "name_prefix": "Mr.",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dalbir Kaur Khalsa, P.A.
• Adil Khan
• Vanessa Khim
• Mohebbah Khushzad
• Isabelle Anne Kiefer
• Loren Koda Kimble, PT
• Kaitlin Kimmel, LPCC
• Lyndsey Ann Kinane, OT, CHT
• Alina Tsvet King, MA, LMFT
• Ginny King

• Marriage & Family Therapist in Petaluma, CA
• Providers in Petaluma, 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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.