Individual provider Active NPI

Kathleen Marie Anderson, MFC

  • Marriage & Family Therapist
  • Windsor, CA
National Provider Identifier
1679902811
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
49419 Issued in CA
Practice address
930 Shiloh Rd
BLDG 44, Ste. G
Windsor, CA 95492-9659
Phone
(707) 477-9769
Fax
(707) 836-1997
NPI assigned
Nov 7, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 49419 CA Primary

Addresses

Primary practice location

930 Shiloh Rd
BLDG 44, Ste. G
Windsor, CA 95492-9659

Mailing address

930 Shiloh Rd
BLDG 44, Ste. G
Windsor, CA 95492-9659
Phone (707) 477-9769

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
I20260223002701 CA Practitioner - Marriage and Family Therapist 6002397577 Practice locations: Windsor, CA

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8107 Luisa Way
Windsor, CA 95492-7741

930 Shiloh Rd
Suite G
Windsor, CA 95492-6681

930 Shiloh Rd
Suite G
Windsor, CA 95492-9659
Phone (707) 477-9769

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
49419CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1679902811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 SHILOH RD",
            "address_2": "BLDG 44, STE. G",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929659",
            "telephone_number": "707-477-9769",
            "fax_number": "707-836-1997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SHILOH RD",
            "address_2": "BLDG 44, STE. G",
            "city": "WINDSOR",
            "state": "CA",
            "postal_code": "954929659",
            "telephone_number": "707-477-9769",
            "fax_number": "707-836-1997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "KATHLEEN",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MFC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "49419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Windsor, CA

Sources for this page

Verify at the official NPI Registry.