Individual provider Active NPI

Kimberly Ann Fabbri, MFT

  • Marriage & Family Therapist
  • San Miguel, CA
National Provider Identifier
1710054879
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
40192 Issued in CA
Practice address
77011 Douglas Rd
San Miguel, CA 93451-9099
Phone
(831) 682-4946
NPI assigned
Nov 30, 2006
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2024

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 40192 CA Primary

Addresses

Primary practice location

77011 Douglas Rd
San Miguel, CA 93451-9099

Mailing address

77011 Douglas Rd
San Miguel, CA 93451-9099
Phone (831) 682-4946

Other names 1

  • Kimberly Ann Fabbri-Devos Professional name

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

LicenseStateTypeSpecialty
40192CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1710054879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77011 DOUGLAS RD",
            "city": "SAN MIGUEL",
            "state": "CA",
            "postal_code": "934519099",
            "telephone_number": "831-682-4946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77011 DOUGLAS RD",
            "city": "SAN MIGUEL",
            "state": "CA",
            "postal_code": "934519099",
            "telephone_number": "831-682-4946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FABBRI",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "40192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "FABBRI-DEVOS",
            "middle_name": "ANN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Miguel, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.