MR. KELLY GENE COBURN (NPI# 1750633970) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750633970 |
| Entity Type | Individual |
| Full Name | MR. KELLY GENE COBURN |
| Credential | LMFT |
| Practice Address |
2035 E Ball Rd Ste. 100-a Anaheim CA 92806-5159 |
| Practice Telephone | 7145176152 |
| Mailing Telephone | 7145176152 |
| Enumeration Date | 2012-10-11 |
| Last Update Date | 2019-11-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | 112266 | CA | Behavioral Health & Social Service Providers |
| N | 106H00000X | Marriage & Family Therapist | 89020 | CA | Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881962488 | Kelly Lynn Coburn | Speech-Language Pathologist | 30 Warren St, Speech-language-hearing, Brighton, MA 02135-3602 | 2011-12-09 |
| Street Address |
2035 E BALL RD STE. 100-A |
| City | ANAHEIM |
| State | CA |
| Zip Code | 92806-5159 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992803357 | Teri Eileen Consunji | Marriage & Family Therapist | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2006-09-20 |
| 1598329930 | Jazmine Monique Fisher | Counselor | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2019-04-30 |
| 1215410568 | Liceth Ramirez | Marriage & Family Therapist | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2018-09-12 |
| 1629559299 | William Larkin | Counselor | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2018-08-22 |
| 1023596962 | Maria Del Rosario Alvarez | Social Worker | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2018-08-02 |
| 1073099974 | David Michael Boyajian | Marriage & Family Therapist | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2018-07-13 |
| 1386134385 | Raul Gomez | Counselor | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2018-05-15 |
| 1366961005 | Brian Tuason | Registered Nurse | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2017-09-13 |
| 1104360924 | Jasmin Carnelus | Marriage & Family Therapist | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2016-12-13 |
| 1427509108 | Navneet Kaur | Registered Nurse | 2035 E Ball Rd, Anaheim, CA 92806-5159 | 2016-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619513611 | Krista Mckinney | Family Medicine | 344o E. La Palma Avenue, Anaheim, CA 92806 | 2019-11-25 |
| 1780175968 | Brooke Lindsay Owen | Specialist/Technologist | 1300 N. Kraemer Blvd, Anaheim, CA 92806 | 2018-05-23 |
| 1033631973 | Biocorrx Inc. | Rehabilitation, Substance Use Disorder Unit | 2390 E Orangewood Avenue, Suite 575, Anaheim, CA 92806 | 2017-07-12 |
| 1437679784 | Margaret Elena Popp | Counselor | Adult and Older Adult Behavioral Health Services, 2035 E. Ball Rd, Anaheim, CA 92806 | 2017-06-27 |
| 1982134581 | Jessica Nguyen | Pharmacist | 2833 E Randy Ave, Anaheim, CA 92806 | 2017-06-15 |
| 1518493733 | Oksana Pradun | Nurse Practitioner | 2111 East Ball Rd., Anaheim, CA 92806 | 2017-05-08 |
| 1568828754 | Sanah Qureshi | Nurse Anesthetist, Certified Registered | 2546 E Strong Pl, Anaheim, CA 92806 | 2016-01-05 |
| 1689050379 | Wu Chiropractic Care, Inc. | Acupuncturist | 215 N State College Blvd., #b, Anaheim, CA 92806 | 2015-08-04 |
| 1659757375 | Jonathan Song | Dentist | 1134 N State College Blvd Ste C, Anaheim, CA 92806 | 2015-08-04 |
| 1558764761 | Mariko Horie | Acupuncturist | 504 N State College Blvd, Anaheim, CA 92806 | 2014-10-01 |
| Find all providers in zip 92806 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676337 | Ezra Lim | Marriage & Family Therapist | 8870 E Garden View Dr, Anaheim, CA 92808-1677 | 2020-07-07 |
| 1396362158 | Meredith L Stanton | Marriage & Family Therapist | 5241 E Santa Ana Canyon Rd Ste 132, Anaheim, CA 92807-3744 | 2020-06-28 |
| 1962058578 | Michael Bergeron | Marriage & Family Therapist | 9941 Chanticleer Rd, Anaheim, CA 92804-5625 | 2019-08-11 |
| 1881248706 | Penelope Anne Valenzuela | Marriage & Family Therapist | 5101 E La Palma Ave Ste 100g, Anaheim, CA 92807-2056 | 2019-07-29 |
| 1598327439 | Jennifer Lucas | Marriage & Family Therapist | 160 W Center Street Promenade Unit 112, Anaheim, CA 92805-3986 | 2019-07-01 |
| 1588155998 | Judith Arlene Hails | Marriage & Family Therapist | 101 E Lincoln Ave Ste 230, Anaheim, CA 92805-3206 | 2018-05-21 |
| 1942791595 | Brenna Renae Kress | Marriage & Family Therapist | 6200 E Canyon Rim Rd Ste 212, Anaheim, CA 92807-4317 | 2018-05-18 |
| 1639627086 | Dorothy D O'neill | Marriage & Family Therapist | 6200 E Canyon Rim Rd Ste 215, Anaheim, CA 92807-4317 | 2016-09-14 |
| 1487100798 | Gary Lira | Marriage & Family Therapist | 2272 W Colchester Dr, Apt. 1, Anaheim, CA 92804-4255 | 2016-08-27 |
| 1376991349 | Deana Helmy | Marriage & Family Therapist | 2180 W Crescent Ave Ste C, Anaheim, CA 92801-3842 | 2016-05-31 |
| Find all providers in ANAHEIM | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.