Active NPI
Kyla Winner-Connor
- Mental Health Counselor
- Culver City, CA
National Provider Identifier
1659930790
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 89437
- Practice address
- 4760 Sepulveda Blvd
Culver City, CA 90230-4820 - Phone
- (310) 390-6612
- Fax
- (310) 398-5690
- NPI assigned
- Jun 12, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 89437 | CA | Primary |
| Social Worker | 104100000X |
Addresses
Primary practice location
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Mailing address
4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone (310) 390-6612
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
| License | State | Type | Specialty |
|---|---|---|---|
| 89437 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1614556800000",
"number": "1659930790",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4760 SEPULVEDA BLVD",
"city": "CULVER CITY",
"state": "CA",
"postal_code": "902304820",
"telephone_number": "310-390-6612",
"fax_number": "310-398-5690"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WINNER-CONNOR",
"first_name": "KYLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-12",
"last_updated": "2021-03-01",
"certification_date": "2021-03-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "89437",
"primary": true
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Culver City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.