Keith McCormick

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

164494 Issued in CA

Practice address

1370 S State St Ste a
San Jacinto, CA 92583-4922

Phone

(951) 791-3300

NPI assigned

Apr 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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.

{
    "created_epoch": "1619049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788048000000",
    "number": "1790367498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2431",
            "city": "HEMET",
            "state": "CA",
            "postal_code": "925462431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1370 S STATE ST STE A",
            "city": "SAN JACINTO",
            "state": "CA",
            "postal_code": "925834922",
            "telephone_number": "951-791-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "234 Elmwood Ave",
            "address_purpose": "LOCATION",
            "city": "Hemet",
            "state": "CA",
            "postal_code": "925435912",
            "country_code": "US",
            "telephone_number": "951-259-3827",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "KEITH",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-04-22",
        "last_updated": "2026-08-30",
        "certification_date": "2026-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "164494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Annmary Wairimu Mbui, RN
• Christine Ann MC Millan
• Scott Alan McClung, MFT
• Natalie Lynn McCormack, RADT1
• Debra Lynn McCormick, LCSW
• Rezana Katrice McCray, PPS
• Herlyn McIntosch Leiva
• Timothy Paul McLaughlin, M.A
• Erika B McNeill
• Kelly Ellen Mead

• Marriage & Family Therapist in San Jacinto, CA
• Providers in San Jacinto, 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 Aug 30, 2026; 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.