Sally Kathleen Pearson Kent, MFT
Individual provider Active NPI Marriage & Family Therapist · Coarsegold, CA
NPI 1649436379 · NPPES record last updated Jun 3, 2024
Key facts
- NPI
- 1649436379
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 42563 (CA)
- Practice address
- 29025 Acorn CT
Coarsegold, CA 93614-9691 - Phone
- (530) 520-4763
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240411004004 | CA | Practitioner - Marriage and Family Therapist | 0042659989 | Practice locations: Coarsegold, CA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Teladoc Health Medical Group, P.a. | Marriage & Family Therapist | Current | Accepting new patients |
Interoperability endpoints
- sallykent@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 42563 | CA | Yes |
Addresses
Primary practice location
29025 Acorn CT
Coarsegold, CA 93614-9691
Mailing address
29025 Acorn CT
Coarsegold, CA 93614-9691
Phone (530) 520-4763
Other providers in Coarsegold, CA
- John Eric Francom
- Tracy Lee Frederick
- Darren Gibbons
- Stefanie Marie Gibbons
- Rachel Marie Gren
- Faynalda Joann King
- Kroeger Enterprises LLC
- Phillip Brandon Kroeger
- Tamara Lee Kroeger
- George Samuel Laird Jr.
All providers in Coarsegold, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.