Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MRS. RAECHELE KENYON-DIAZ LMFT
NPI 1477093672
Marriage & Family Therapist in Sausalito, CA

Q: What is Raechele Kenyon-diaz's NPI number?

The NPI number for Raechele Kenyon-diaz is 1477093672. It was assigned to this individual provider in the NPPES registry on March 7, 2017.

Q: What is Raechele Kenyon-diaz's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Active since March 07, 2017PECOS EnrolledAccepts Medicare Assignment

100 PHILLIPS DR, SAUSALITO, CA 94965(415) 339-8813(415) 339-8814 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 3, 2026, Oct 23, 2023 (2 updates tracked since 2023).

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About Mrs. Raechele Kenyon-diaz Lmft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. RAECHELE KENYON-DIAZ LMFT (NPI 1477093672) is an individual marriage & family therapist in Sausalito, California, licensed in California (140052) and active in the NPI registry since March 2017. She is enrolled in Medicare PECOS, maintains a secondary practice location in Redding, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1477093672

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameMRS. RAECHELE KENYON-DIAZCredential: LMFT

Location Address100 PHILLIPS DRSausalito, CA 94965-1172

Mailing Address100 Phillips DrSausalito, CA 94965-1172 · (415) 339-8813 · Fax (415) 339-8814

Phone(415) 339-8813

Fax(415) 339-8814

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 7, 2017

Last NPPES UpdateSeptember 3, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2026

✔ NPI 1477093672 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

License✔ Licensed in CA · 140052

Definition

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.

Also ListedLicensed Vocational NurseTaxonomy 164X00000X · License VN256371 (CA)

100 PHILLIPS DR, Sausalito, CA 94965

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Secondary Practice Location 1

Location 12640 Breslauer WayRedding, CA 96001-4246 · Phone (530) 225-5200

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Raechele Kenyon-diaz Lmft is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7113365024

PECOS Enrollment IDI20240410002414

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KENDRA THOMAS DMD

Dentist (General Practice)