NPIMap

Organization Active NPI

K Allen Family Therapist Inc

  • Clinical Psychologist
  • Laguna Hills, CA
National Provider Identifier
1720384142
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
26567 Issued in CA
Legal business name
K ALLEN FAMILY THERAPIST INC
Practice address
23961 Calle de la Magdalena
Suite 424
Laguna Hills, CA 92653-3616
Phone
(949) 630-0584
Fax
(949) 663-0058
NPI assigned
Feb 2, 2011
Last updated
Aug 11, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Authorized official

Name
Dr. Kanita Elizabeth Allen, PSY.D.NPI 1972826790
Title
President & Ceo
Phone
(949) 421-7922

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 26567 CA Primary

Addresses

Primary practice location

23961 Calle de la Magdalena
Suite 424
Laguna Hills, CA 92653-3616

Mailing address

4 Collingwood
Aliso Viejo, CA 92656-1939
Phone (949) 421-7922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140822000325 CA Part B Supplier - Clinic/Group Practice 1951529775 Receives reassigned benefits from 9 practitioners
Practice locations: Aliso Viejo, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1296604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407715200000",
    "number": "1720384142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COLLINGWOOD",
            "city": "ALISO VIEJO",
            "state": "CA",
            "postal_code": "926561939",
            "telephone_number": "949-421-7922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23961 CALLE DE LA MAGDALENA",
            "address_2": "SUITE 424",
            "city": "LAGUNA HILLS",
            "state": "CA",
            "postal_code": "926533616",
            "telephone_number": "949-630-0584",
            "fax_number": "949-663-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K ALLEN FAMILY THERAPIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-02",
        "last_updated": "2014-08-11",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "KANITA",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "949-421-7922",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "26567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laguna Hills, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.