Active NPI
Jessica Kinon
- Marriage & Family Therapist
- Santa Rosa, CA
National Provider Identifier
1932545142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- IMF74165
- Practice address
- 1421 Guerneville Rd Ste 218
Santa Rosa, CA 95403-7255 - Phone
- (707) 576-7700
- NPI assigned
- May 14, 2013
- Sex
- Female
- Sole proprietor
- No
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 | IMF74165 | CA | Primary |
Addresses
Primary practice location
1421 Guerneville Rd Ste 218
Santa Rosa, CA 95403-7255
Mailing address
1421 Guerneville Rd Ste 218
Santa Rosa, CA 95403-7255
Phone (707) 576-7700
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 |
|---|---|---|---|
| IMF74165 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1368489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1439164800000",
"number": "1932545142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1421 GUERNEVILLE RD STE 218",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954037255",
"telephone_number": "707-576-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 GUERNEVILLE RD STE 218",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954037255",
"telephone_number": "707-576-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KINON",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-14",
"last_updated": "2015-08-10",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "IMF74165",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.