Individual provider Active NPI

Kyla Dena Campbell, MS, LMFT

  • Marriage & Family Therapist
  • Anaheim, CA
National Provider Identifier
1669937868
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
143440 Issued in CA
Practice address
505 S Villa Real Ste 117
Anaheim, CA 92807-3441
Phone
(949) 441-5427
NPI assigned
Feb 1, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Marriage & Family Therapist 106H00000X 143440 CA Primary

Addresses

Primary practice location

505 S Villa Real Ste 117
Anaheim, CA 92807-3441

Mailing address

PO Box 1563
Brea, CA 92822-1563

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
I20240620000024 CA Practitioner - Marriage and Family Therapist 5799228664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Center for New Directions Inc 32 clinicians

Practice addresses (Care Compare)

23201 Mill Creek Dr
Suite 220
Laguna Hills, CA 92653-7906
Phone (888) 795-4337

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
143440CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen M Pumphrey Licensed Clinical Social Workers Inc Single Specialty CurrentSince Apr 10, 2024 Accepting new patients
Center for New Directions, Inc. Mental Health CurrentSince Apr 10, 2024 Accepting new patients

Locations

23201 Mill Creek Dr
Ste 220
Laguna Hills, CA 92653
Phone (949) 460-5320

1100 Melody Ln
Ste 108
Roseville, CA 95678

Organizations & group practices 2

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": "1548979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1669937868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1563",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928221563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S VILLA REAL STE 117",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928073441",
            "telephone_number": "949-441-5427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPBELL",
        "first_name": "KYLA",
        "middle_name": "DENA",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-01",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "143440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

Verify at the official NPI Registry.