Healthcare Provider Details

I. General information

NPI: 1942130406
Provider Name (Legal Business Name): KF MARRIAGE & FAMILY THERAPY, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44325 APACHE PLUME ST
LANCASTER CA
93536-2202
US

IV. Provider business mailing address

44620 VALLEY CENTRAL WAY # 1106
LANCASTER CA
93536-6533
US

V. Phone/Fax

Practice location:
  • Phone: 661-674-8789
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: NICOLE TRACY
Title or Position: PRESIDENT
Credential: TRACY
Phone: 661-674-8789