Individual provider Active NPI

Katherine Kiley, AMFT

  • Mental Health Counselor
  • Sonora, CA
National Provider Identifier
1720339229
Registry record updated Jun 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
105 Hospital Road
Sonora, CA 95370-5227
Phone
(209) 533-6245
NPI assigned
Sep 24, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X CA Primary
Marriage & Family Therapist 106H00000X AMFT111997 CA

Addresses

Primary practice location

105 Hospital Road
Sonora, CA 95370-5227

Mailing address

2 S. Green St
Sonora, CA 95370-4518
Phone (209) 533-6245

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
AMFT111997CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Tuolumne CurrentSince Jun 14, 2020 Accepting new patients
County of Tuolumne CurrentSince Jun 14, 2020 Accepting new patients

Locations

2 S Green St
Sonora, CA 95370

105 Hospital Rd
Sonora, CA 95370
Phone (209) 533-6245

Organizations & group practices 2

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": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1720339229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S. GREEN ST",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953704518",
            "telephone_number": "209-533-6245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HOSPITAL ROAD",
            "city": "SONORA",
            "state": "CA",
            "postal_code": "953705227",
            "telephone_number": "209-533-6245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILEY",
        "first_name": "KATHERINE",
        "credential": "AMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT111997",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sonora, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.