Kim Thu Tran, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

142756 Issued in CA

Practice address

561 Saxony PL Ste 101
Encinitas, CA 92024-7700

Phone

(760) 503-4703

NPI assigned

Jul 9, 2019

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Jul 13, 2024 through Jul 13, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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 and National Provider Directory roles.

• Bold Health Medical Group, a Professional Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Encinitas, CA
  • NPI 1245749688
  NPD

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1801448014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2704 55TH ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921055044",
            "telephone_number": "619-793-6802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 SAXONY PL STE 101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247700",
            "telephone_number": "760-503-4703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAN",
        "first_name": "KIM",
        "middle_name": "THU",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT123911",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "142756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Lincoln Tracer, MSW
• Samuel Tracer, LCSW
• Amy Tran, MD
• Betty Tran, DPT
• Joyce Diane Tran
• Richard Tran, M.D.
• Carolyn Travis, MOTR/L
• Tree of Life for Healthy Birthing and Parenting
• Paul-Thomas Tremoulet, M.D.
• Kenneth G Trestman, MD

• Marriage & Family Therapist in Encinitas, CA
• Providers in Encinitas, 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 Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.