Individual provider Active NPI

Kiabeth Reynoso Renteria, LPCC

  • Professional Counselor
  • Elk Grove, CA
National Provider Identifier
1639668353
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPCC19454 Issued in CA
Practice address
9355 E Stockton Blvd Ste 230
Elk Grove, CA 95624-9526
Phone
(000) 000-0000
NPI assigned
May 8, 2018
Reactivated
Feb 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPCC19454 CA Primary
Mental Health Counselor 101YM0800X APCC8941 CA
Behavior Technician 106S00000X RBT-18-48872 CA

Addresses

Primary practice location

9355 E Stockton Blvd Ste 230
Elk Grove, CA 95624-9526

Mailing address

PO Box 291
Galt, CA 95632-0291

Other practice location 1

9601 Kiefer Blvd
Sacramento, CA 95827-3818
Phone (916) 875-5150

Other practice location 2

414 4th St Ste D
Woodland, CA 95695-4000
Phone (530) 406-7993

Other practice location 3

9755 Lincoln Village Dr
Sacramento, CA 95827-3334
Phone (916) 363-6103

Other practice location 4

2800 Stonecreek Dr
Sacramento, CA 95833-1634
Phone (916) 363-6103

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240427001872 CA Practitioner - Mental Health Counselor 2163862913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APCC8941CAMDMental Health Counselor
LPCC19454CAMDProfessional Counselor
RBT-18-48872CAMDBehavior Technician
8941CAMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Kids Past Accepting new patients
Advance Kids Past Accepting new patients

Organizations & group practices 3

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": "1525737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772064000000",
    "number": "1639668353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 291",
            "city": "GALT",
            "state": "CA",
            "postal_code": "956320291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9355 E STOCKTON BLVD STE 230",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "956249526",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9601 Kiefer Blvd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958273818",
            "country_code": "US",
            "telephone_number": "916-875-5150",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "414 4th St Ste D",
            "address_purpose": "LOCATION",
            "city": "Woodland",
            "state": "CA",
            "postal_code": "956954000",
            "country_code": "US",
            "telephone_number": "530-406-7993",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9755 Lincoln Village Dr",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958273334",
            "country_code": "US",
            "telephone_number": "916-363-6103",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Stonecreek Dr",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958331634",
            "country_code": "US",
            "telephone_number": "916-363-6103",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYNOSO RENTERIA",
        "first_name": "KIABETH",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-08",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "deactivation_date": "2026-02-24",
        "reactivation_date": "2026-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC19454",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "APCC8941",
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": "RBT-18-48872",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

Verify at the official NPI Registry.