Autumn Fannin McKamie, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

124088 Issued in CA

Practice address

4255 Campus Dr Ste A245
Irvine, CA 92612-8630

Phone

(888) 699-4873

NPI assigned

Dec 29, 2016

Last updated

Mar 9, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Autumn Fannin Former name

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, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment NPD
• Acacia Psychological Corporation

  dba Acacia Counseling & Wellness

  • Psychologist
  • Irvine, CA
  • NPI 1770148827
  NPD (past)
• Accent on Wellness Psychology Associates, Inc.

  • Clinical Psychologist
  • Torrance, CA
  • NPI 1265941165
  NPD (past)

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

{
    "created_epoch": "1482969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615248000000",
    "number": "1851836837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4255 CAMPUS DR STE A245",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128630",
            "telephone_number": "888-699-4873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4255 CAMPUS DR STE A245",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926128630",
            "telephone_number": "888-699-4873"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Skypark Dr Ste 215",
            "address_purpose": "LOCATION",
            "city": "Torrance",
            "state": "CA",
            "postal_code": "905055388",
            "country_code": "US",
            "telephone_number": "310-855-3990",
            "fax_number": "424-276-7676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKAMIE",
        "first_name": "AUTUMN",
        "middle_name": "FANNIN",
        "name_prefix": "Ms.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-29",
        "last_updated": "2021-03-09",
        "certification_date": "2021-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "85468",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "124088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "FANNIN",
            "credential": "M.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jeannie McGuire
• Norah Joyce McHenry-Uy, LCSW
• Amanda McIntyre
• Courtney McIntyre
• Susan McIntyre, LMFT
• McKee Music Therapy Services LLC (Music Therapy Services of Orange County)
• Callum McKeefery
• Tracy McKelvey, RD
• Alison Lynn McKenzie, DPT, PHD
• Lauren McKenzie

• Marriage & Family Therapist in Irvine, CA
• Providers in Irvine, 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 Mar 9, 2021; 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.