Individual provider Active NPI

Kathryn Stull Whitaker, MFT

  • Marriage & Family Therapist
  • Corona, CA
National Provider Identifier
1720190069
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC20744 Issued in CA
Practice address
707 Magnolia Ave Suite 1F
Inland Psychiatric Medical Group Inc
Corona, CA 92879
Phone
(951) 737-1917
Fax
(951) 735-4105
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MFC20744 CA Primary

Addresses

Primary practice location

707 Magnolia Ave Suite 1F
Inland Psychiatric Medical Group Inc
Corona, CA 92879

Mailing address

101 E Redlands Blvd
Suite 234
Redlands, CA 92373
Phone (909) 335-3026

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
MFC20744CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Past Accepting new patients

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720190069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E REDLANDS BLVD",
            "address_2": "SUITE 234",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "92373",
            "telephone_number": "909-335-3026",
            "fax_number": "909-335-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 MAGNOLIA AVE SUITE 1F",
            "address_2": "INLAND PSYCHIATRIC MEDICAL GROUP INC",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "92879",
            "telephone_number": "951-737-1917",
            "fax_number": "951-735-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STULL WHITAKER",
        "first_name": "KATHRYN",
        "credential": "MFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC20744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.