Active NPI
Katherine Nguyen
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1518314905
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- LMFT108943
- Practice address
- 576 B St Ste 1a
Santa Rosa, CA 95401-5269 - Phone
- (707) 200-8150
- NPI assigned
- May 16, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PCCI2668 | CA | |
| Marriage & Family Therapist | 106H00000X | LMFT108943 | CA | Primary |
Addresses
Primary practice location
576 B St Ste 1a
Santa Rosa, CA 95401-5269
Mailing address
576 B St Ste 1a
Santa Rosa, CA 95401-5269
Phone (707) 200-8150
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240130001345 | CA | Practitioner - Marriage and Family Therapist | 6406209121 | Practice locations: Santa Rosa, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCCI2668 | CA | MD | Professional Counselor |
| LMFT108943 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1612137600000",
"number": "1518314905",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "576 B ST STE 1A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015269",
"telephone_number": "707-200-8150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "576 B ST STE 1A",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015269",
"telephone_number": "707-200-8150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "KATHERINE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-16",
"last_updated": "2021-02-01",
"certification_date": "2021-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "PCCI2668",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "LMFT108943",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; 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.