Individual provider Active NPI

Krystle Gail Herbert, LMFT, PSYD ABD

  • Marriage & Family Therapist
  • Playa Vista, CA
National Provider Identifier
1609090562
Registry record updated Jul 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT 80484 Issued in CA
Practice address
12777 West Jefferson Blvd
Building D, #300
Playa Vista, CA 90066
Phone
(323) 696-0386
Fax
(323) 792-4867
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2020

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X IMF48571 CA
Addiction (Substance Use Disorder) Counselor 101YA0400X
Marriage & Family Therapist 106H00000X IMF48571 CA
Rehabilitation Practitioner 225400000X
Marriage & Family Therapist 106H00000X LMFT 80484 CA Primary

Addresses

Primary practice location

12777 West Jefferson Blvd
Building D, #300
Playa Vista, CA 90066

Mailing address

5032 Inadale Ave
Los Angeles, CA 90043-1514
Phone (310) 968-2364

Other names 1

  • Krystle Gail Hays Former name

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
IMF48571CAMDMarriage & Family Therapist
LMFT 80484CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Health & Healing Company Addiction (Substance Use Disorder) CurrentSince Nov 5, 2023 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594771200000",
    "number": "1609090562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5032 INADALE AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900431514",
            "telephone_number": "310-968-2364",
            "fax_number": "323-792-4867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12777 WEST JEFFERSON BLVD",
            "address_2": "BUILDING D, #300",
            "city": "PLAYA VISTA",
            "state": "CA",
            "postal_code": "90066",
            "telephone_number": "323-696-0386",
            "fax_number": "323-792-4867"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERBERT",
        "first_name": "KRYSTLE",
        "middle_name": "GAIL",
        "credential": "LMFT, PSYD ABD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2020-07-15",
        "certification_date": "2020-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "IMF48571",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "IMF48571",
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT 80484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "HAYS",
            "middle_name": "GAIL",
            "credential": "LMFT, PSYD ABD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Playa Vista, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2020; 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.