Active NPI
Justina Kimball
- Marriage & Family Therapist
- Newbury Park, CA
National Provider Identifier
1669254207
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 122967
- Practice address
- 872 Cayo Grande CT
Newbury Park, CA 91320-1943 - Phone
- (805) 732-2104
- NPI assigned
- Oct 18, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 122967 | CA | Primary |
Addresses
Primary practice location
872 Cayo Grande CT
Newbury Park, CA 91320-1943
Mailing address
872 Cayo Grande CT
Newbury Park, CA 91320-1943
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1697587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1697587200000",
"number": "1669254207",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "872 CAYO GRANDE CT",
"city": "NEWBURY PARK",
"state": "CA",
"postal_code": "913201943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "872 CAYO GRANDE CT",
"city": "NEWBURY PARK",
"state": "CA",
"postal_code": "913201943",
"telephone_number": "805-732-2104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "JUSTINA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-10-18",
"last_updated": "2023-10-18",
"certification_date": "2023-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "122967",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newbury Park, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.