Active NPI
Keith Elliot Kerns, MFT
- Marriage & Family Therapist
- Sonora, CA
National Provider Identifier
1922002971
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 23993
- Practice address
- 193 Fairview LN Ste K
Sonora, CA 95370-4828 - Phone
- (209) 586-2249
- Fax
- (209) 586-2249
- NPI assigned
- Jun 8, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 23993 | CA | Primary |
Addresses
Primary practice location
193 Fairview LN Ste K
Sonora, CA 95370-4828
Mailing address
PO Box 4386
Sonora, CA 95370-1386
Phone (209) 586-2249
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 23993 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238544000000",
"number": "1922002971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4386",
"city": "SONORA",
"state": "CA",
"postal_code": "953701386",
"telephone_number": "209-586-2249",
"fax_number": "209-586-2249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "193 FAIRVIEW LN STE K",
"city": "SONORA",
"state": "CA",
"postal_code": "953704828",
"telephone_number": "209-586-2249",
"fax_number": "209-586-2249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERNS",
"first_name": "KEITH",
"middle_name": "ELLIOT",
"name_prefix": "Mr.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-06-08",
"last_updated": "2009-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 23993",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Sonora, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.