Individual provider Active NPI

Kymberli Ann Boynton, PSY.D

  • Marriage & Family Therapist
  • Wildomar, CA
National Provider Identifier
1699435750
Registry record updated Oct 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Practice address
34878 Monte Vista Dr Ste 120
Wildomar, CA 92595-7006
Phone
(951) 291-7566
NPI assigned
Dec 29, 2021
Reactivated
Oct 10, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2025

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: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Marriage & Family Therapist 106H00000X CA Primary

Addresses

Primary practice location

34878 Monte Vista Dr Ste 120
Wildomar, CA 92595-7006

Mailing address

34878 Monte Vista Dr Ste 120
Wildomar, CA 92595-7006
Phone (951) 291-7566

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
I20251119001257 CA Practitioner - Marriage and Family Therapist 2769973593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2201 Creston CT
Medford, OR 97504-2161

36330 Hidden Springs Rd
Suite E
Wildomar, CA 92595-5803

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
532730CAMDPsychiatric/Mental Health Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Taylormade Counseling & Consulting, LLC Mental Health CurrentSince Sep 6, 2025 Accepting new patients
Renewing Hope Family Counseling Center, Inc Marriage & Family Therapist PastSince Jan 1, 2022 Accepting new patients
Renewing Hope Strategies Mental Health PastSince Jun 4, 2023 Accepting new patients

Locations

36330 Hidden Springs Rd
Ste E
Wildomar, CA 92595
Phone (442) 224-3320

Organizations & group practices 3

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": "1640736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760140800000",
    "number": "1699435750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34878 MONTE VISTA DR STE 120",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957006",
            "telephone_number": "951-291-7566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34878 MONTE VISTA DR STE 120",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957006",
            "telephone_number": "951-291-7566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYNTON",
        "first_name": "KYMBERLI",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-29",
        "last_updated": "2025-10-11",
        "certification_date": "2025-10-11",
        "deactivation_date": "2025-08-22",
        "reactivation_date": "2025-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wildomar, CA

Sources for this page

Verify at the official NPI Registry.