Individual provider Active NPI

Kimara Lani Houseman

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1558788083
Registry record updated Dec 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
77548 Issued in CA
Practice address
11526 Sorrento Valley Rd Ste F
San Diego, CA 92121-1314
Phone
(858) 224-2838
NPI assigned
Mar 21, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2021

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 77548 CA Primary

Addresses

Primary practice location

11526 Sorrento Valley Rd Ste F
San Diego, CA 92121-1314

Mailing address

3002 Armstrong St
San Diego, CA 92111-5702
Phone (858) 277-9550

Other practice location 1

3002 Armstrong St
San Diego, CA 92111-5702
Phone (858) 277-9550

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

State licenses

LicenseStateTypeSpecialty
77548CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1395360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639008000000",
    "number": "1558788083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3002 ARMSTRONG ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921115702",
            "telephone_number": "858-277-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11526 SORRENTO VALLEY RD STE F",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921211314",
            "telephone_number": "858-224-2838"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3002 Armstrong St",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921115702",
            "country_code": "US",
            "telephone_number": "858-277-9550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOUSEMAN",
        "first_name": "KIMARA",
        "middle_name": "LANI",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-21",
        "last_updated": "2021-12-09",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "77548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2021; 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.