Kyla Breanne McClure

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

149116 Issued in CA

Practice address

1700 Standiford Ave Ste 355
Modesto, CA 95350-6534

Phone

(855) 501-1004

Fax

(209) 661-4673

NPI assigned

Dec 17, 2020

Last updated

Sep 24, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mark David Levine MD Professional CorporationGroup PAC ID 0143478305, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mark David Levine M.D. Professional Corporation

  dba Mindpath Health

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1154697944

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Mark David Levine, MD Burlingame PC

  dba Community Psychiatry Associates

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1770709263
  NPD

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

{
    "created_epoch": "1608163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727136000000",
    "number": "1750977344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3835 N FREEWAY BLVD STE 100",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958341954",
            "telephone_number": "916-576-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 STANDIFORD AVE STE 355",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953506534",
            "telephone_number": "855-501-1004",
            "fax_number": "209-661-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLURE",
        "first_name": "KYLA",
        "middle_name": "BREANNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-17",
        "last_updated": "2024-09-24",
        "certification_date": "2024-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "149116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quincyetta Marie McClain
• Michael McClanahan, D.C.
• Cynthia Marie McCleary
• Andrew McClure
• Cristian Brittney McClure
• Nancy Lee McClure, PHN
• Miranda McComber
• Jadyn McCombs
• David Lewis McCord, LMFT
• Kathryn McCormack

• Marriage & Family Therapist in Modesto, CA
• Providers in Modesto, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.