Individual provider Active NPI

Corynne Marie Keirnes, M.S. LMFT

  • Marriage & Family Therapist
  • Brea, CA
National Provider Identifier
1578153201
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
108819 Issued in CA
Practice address
265 S Randolph Ave Ste 250
Brea, CA 92821-5701
Phone
(657) 341-5717
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 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 108819 CA Primary

Addresses

Primary practice location

265 S Randolph Ave Ste 250
Brea, CA 92821-5701

Mailing address

265 S Randolph Ave Ste 250
Brea, CA 92821-5701
Phone (657) 341-5717

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Apr 30, 2025 through Apr 30, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
108819CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611792000000",
    "number": "1578153201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 250",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215701",
            "telephone_number": "657-341-5717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 S RANDOLPH AVE STE 250",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928215701",
            "telephone_number": "657-341-5717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEIRNES",
        "first_name": "CORYNNE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S. LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "108819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

Verify at the official NPI Registry.