Mary Kilkenny Williams, MFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFT22544 Issued in CA

Practice address

40400 Mt View Rd
Manchester, CA 95459

Phone

(707) 882-2477

Fax

(702) 882-2477

NPI assigned

Sep 11, 2007

Sex

Female

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 11, 2007.

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189468800000",
    "number": "1740475987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 343",
            "city": "POINT ARENA",
            "state": "CA",
            "postal_code": "954680343",
            "telephone_number": "707-882-2477",
            "fax_number": "707-882-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40400 MT VIEW RD",
            "city": "MANCHESTER",
            "state": "CA",
            "postal_code": "95459",
            "telephone_number": "707-882-2477",
            "fax_number": "702-882-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "MARY",
        "middle_name": "KILKENNY",
        "name_prefix": "Ms.",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2007-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFT22544",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "MFT225440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Christine Polainer, MCT

• All providers in Manchester, CA
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.