SKT Therapy Inc

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

93637 Issued in CA

Legal business name

SKT THERAPY INC

Practice address

765 N Main St Ste 130-A10
Corona, CA 92878-1440

Phone

(650) 252-0300

NPI assigned

Aug 24, 2018

Organization subpart

No

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

Authorized official

Name

Shannon Klosak, LMFTNPI 1013356229

Title

Owner

Phone

(650) 252-0300

Specialties & licenses 1

Addresses

Other names 1

• SKT THERAPY Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Klosak, LMFT

  • Marriage & Family Therapist
  • Long Beach, CA
  • NPI 1013356229
  NPD Authorized official

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621382400000",
    "number": "1629559802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 N MAIN ST STE 130-A10",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928781440",
            "telephone_number": "650-252-0300",
            "fax_number": "951-735-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N MAIN ST STE 130-A10",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928781440",
            "telephone_number": "650-252-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKT THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-24",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A",
        "authorized_official_last_name": "KLOSAK",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "650-252-0300",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "93637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SKT THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Marriage & Family Therapist in Corona, CA
• Providers in Corona, 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 May 19, 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.