KIMI MACK (NPI# 1952786550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952786550 |
| Entity Type | Individual |
| Full Name | KIMI MACK |
| Credential | LMFT, LPCC |
| Practice Address |
2400 Moorpark Ave Ste 300 San Jose CA 95128-2680 |
| Practice Telephone | 4089752730 |
| Enumeration Date | 2015-07-24 |
| Last Update Date | 2020-03-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Street Address |
2400 MOORPARK AVE STE 300 |
| City | SAN JOSE |
| State | CA |
| Zip Code | 95128-2680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366500282 | Samantha W Chen | Marriage & Family Therapist | 2400 Moorpark Ave Ste 300, San Jose, CA 95128 | 2006-12-04 |
| 1992302996 | Lillian Lai | Social Worker | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-10-03 |
| 1619584232 | Felicia Hwung | Registered Nurse | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-09-28 |
| 1558970541 | Sherry Lin | Counselor | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-07-27 |
| 1326656711 | Martha Estela Polanco | Counselor | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-07-21 |
| 1932717584 | Karen Wilson | Student in an Organized Health Care Education/Training Program | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-07-20 |
| 1740898964 | Nan Yang | Counselor | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-07-14 |
| 1497371462 | Shuyang Zhang | Counselor | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-06-24 |
| 1811512981 | Sarah Lustiger | Counselor | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-06-14 |
| 1467077768 | Kathryn Elaine Rennie | Marriage & Family Therapist | 2400 Moorpark Ave Ste 300, San Jose, CA 95128-2680 | 2020-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982227138 | Ruth Larsen | Social Worker | 850 S. Bascom Avenue, Suite 280, San Jose, CA 95128 | 2020-05-22 |
| 1265067185 | Of Two Minds Psychotherapy | Marriage & Family Therapist | 190 S. Bascom Ave, Ste 130, San Jose, CA 95128 | 2020-03-11 |
| 1982244166 | Cindy Pantoja Escobar | Behavior Technician | 100 O'connor Drive, Suites 21, San Jose, CA 95128 | 2020-01-15 |
| 1104460591 | Katherine Alexandra Misogas | Pharmacist | 777 Turner Dr # 330, San Jose, CA 95128 | 2019-10-29 |
| 1942842216 | Jodie Pierce | Marriage & Family Therapist | 871 Enborg Lane, San Jose, CA 95128 | 2019-10-08 |
| 1003466434 | Dong Mi Cha | Pharmacist | 777 Turner Dr Ste 330, San Jose, CA 95128 | 2019-09-17 |
| 1114571759 | Sleep Well Acupuncture, Inc | Acupuncturist | 1361 S Winchester Blvd Suite 206, San Jose, CA 95128 | 2019-08-01 |
| 1083277677 | Wellocity, Inc | Health Educator | 334 Santana Row, 318, San Jose, CA 95128 | 2019-04-18 |
| 1518428812 | Alexander Diaz | Radiology | 75 South Bascom Ave, San Jose, CA 95128 | 2019-03-28 |
| 1720542103 | Nanci R Price Inc | Chiropractor | 100 O'connor Dr., Ste 27, San Jose, CA 95128 | 2019-01-30 |
| Find all providers in zip 95128 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912507021 | Lucid Lane Providers, P.C. | Counselor | 3251 Place Du Jardin, Optional, San Jose, CA 95148-9514 | 2020-10-28 |
| 1700491800 | Sean Garcia | Counselor | 2959 Carrington Ct, San Jose, CA 95125-4882 | 2020-09-15 |
| 1659985240 | Meng Chang Licensed Marriage and Family Therapist | Counselor | 1174 Lincoln Ave Ste 8, San Jose, CA 95125-3029 | 2020-09-02 |
| 1932721115 | Ellen C Gagne | Counselor | 290 N 2nd St Ste 202, San Jose, CA 95112-4143 | 2020-05-11 |
| 1215566773 | Michelle L. Powers | Counselor | 2 N Market St Ste 500, San Jose, CA 95113-1211 | 2020-04-06 |
| 1841823069 | Ana Gabriella Marquez | Counselor | 298 Bernal Rd # A, San Jose, CA 95119-1809 | 2020-02-17 |
| 1063044741 | Alyssa N Thompson | Counselor | 423 Los Arboles St, San Jose, CA 95111-2344 | 2020-02-10 |
| 1336770288 | Genevieve Altwer | Counselor | 3150 Almaden Expy Ste 223, San Jose, CA 95118-1253 | 2020-01-29 |
| 1477183705 | Benjamin C Jensen | Counselor | 1366 Petal Way, San Jose, CA 95129-4722 | 2020-01-26 |
| 1659910529 | Fred Finch Youth Center | Counselor | 2625 Zanker Rd Ste 122, San Jose, CA 95134-2130 | 2019-12-24 |
| Find all providers in SAN JOSE | ||||
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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.