Individual provider Active NPI

Cheryl Jean Carnine, LMFT

  • Marriage & Family Therapist
  • Thousand Oaks, CA
National Provider Identifier
1689796633
Registry record updated Sep 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC41876 Issued in CA
Practice address
1336 N Moorpark Rd Ste 274
Thousand Oaks, CA 91360-5224
Phone
(805) 824-5617
NPI assigned
Apr 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2025

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 MFC41876 CA Primary

Addresses

Primary practice location

1336 N Moorpark Rd Ste 274
Thousand Oaks, CA 91360-5224

Mailing address

1336 N Moorpark Rd Ste 274
Thousand Oaks, CA 91360-5224

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
I20251218002776 CA Practitioner - Marriage and Family Therapist 6608361563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

254 Sequoia CT
Apt 22
Thousand Oaks, CA 91360-3816

254 Sequoia CT Apt
Suite 22
Thousand Oaks, CA 91360-3816

500 Westover Dr
Sanford, NC 27330-8941

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MFC41876CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sud Specialty Group - Ca Marriage & Family Therapist CurrentSince Dec 4, 2025 Accepting new patients

Locations

5201 Great America Pkwy
Ste 320
Santa Clara, CA 95054
Phone (323) 968-6182

520 Broadway
Ste 200
Santa Monica, CA 90401
Phone (949) 280-5295

Organizations & group practices 1

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": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1689796633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 N MOORPARK RD STE 274",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1336 N MOORPARK RD STE 274",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913605224",
            "telephone_number": "805-824-5617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARNINE",
        "first_name": "CHERYL",
        "middle_name": "JEAN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-03",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC41876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.