Raphael Kadoory Amir, LMFT, APCC
Individual provider Active NPI Marriage & Family Therapist · Placerville, CA
NPI 1679006191 · NPPES record last updated Jan 22, 2025
Key facts
- NPI
- 1679006191
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 152209 (CA)
- Practice address
- 5168 Honpie Rd
Placerville, CA 95667-8682 - Phone
- (530) 387-4185
- NPI assigned
- Apr 11, 2017
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
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 |
|---|---|---|---|---|
| I20250221000367 | CA | Practitioner - Marriage and Family Therapist | 2961922919 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 152209 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cyti Health PC | Current |
Accepting new patients | |
| Shingle Springs Rancheria | Current |
Accepting new patients | |
| Community Institute for Psychotherapy | Past | Accepting new patients | |
| Community Institute for Psychotherapy | Past | Accepting new patients |
Locations
11801 Pierce St
Riverside, CA 92505
Phone (909) 528-0317
3111 Camino del Rio N
Ste 460
San Diego, CA 92108
402 W Broadway
Ste 400
San Diego, CA 92101
Phone (619) 810-1939
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 7416 | CA | |
| Marriage & Family Therapist | 106H00000X | 152209 | CA | Yes |
Addresses
Primary practice location
5168 Honpie Rd
Placerville, CA 95667-8682
Mailing address
5168 Honpie Rd
Placerville, CA 95667-8682
Phone (530) 387-4185
Other providers in Placerville, CA
- Joe Alfeghaly
- Allagi Behavioral Health Services Inc
- Phyllis V Allen
- Elizabeth Alvarez-Nyante
- Joshua Paul Amador
- Gina Anderson
- Kendra Anderson
- Robert Emmett Anderson
- Suzanne T Anderson
- Kym M Andrews-Cardoza
All providers in Placerville, 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 Jan 22, 2025. 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.