Active NPI
Kimberly Underwood
- Marriage & Family Therapist
- Modesto, CA
National Provider Identifier
1679763940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 47787
- Practice address
- 615 13TH St Ste B
Modesto, CA 95354-2456 - Phone
- (209) 380-4183
- NPI assigned
- Aug 1, 2007
- Last updated
- May 3, 2012
- 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 | 47787 | CA | Primary |
Addresses
Primary practice location
615 13TH St Ste B
Modesto, CA 95354-2456
Mailing address
615 13TH St Ste B
Modesto, CA 95354-2456
Phone (209) 380-4183
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 |
|---|---|---|---|
| 47787 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336003200000",
"number": "1679763940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 13TH ST STE B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953542456",
"telephone_number": "209-380-4183"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "615 13TH ST STE B",
"city": "MODESTO",
"state": "CA",
"postal_code": "953542456",
"telephone_number": "209-380-4183"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UNDERWOOD",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-01",
"last_updated": "2012-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "47787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Modesto, CA
- Emem Ukpabio, FNP
- Daisy Ulloa
- Roselyn Ulloa
- Joshua Umsted
- Jean Underwood
- United Access Transportation
- United Cab LLC (Red Top Taxi, Quality Cab, DeSoto Cab, Touch of Class Taxi , Unitedcab)
- United Cab LLC (Metro, DeSoto Cab, Red Top Taxi, Yellow Cab, Modesto Cab, Quality Cab,)
- United Way of Stanislaus County
- Avery Urban-Wilson
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.