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MS. KIMBO PRICHARD MA, MFT
NPI 1578764403
Marriage & Family Therapist in Berkeley, CA

Active since May 29, 2007Opted out of Medicare · through Jan 1, 2028
2029 DURANT AVE, #204, BERKELEY, CA 94704(510) 859-4776(510) 750-7628 Get Directions Write a Review

NPPES record last updated: June 27, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ms. Kimbo Prichard Ma, Mft NPPES

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

MS. KIMBO PRICHARD MA, MFT (NPI 1578764403) is an individual marriage & family therapist in Berkeley, California, licensed in California (MFC 50264) and active in the NPI registry since May 2007. She has opted out of Medicare through January 1, 2028.

NPPES Registry Identity

NPI1578764403
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameMS. KIMBO PRICHARDCredential: MA, MFT
Location Address2029 DURANT AVE, #204Berkeley, CA 94704-1564
Mailing Address2029 Durant Ave, #204Berkeley, CA 94704-1564 · (510) 859-4776 · Fax (510) 750-7628
Phone(510) 859-4776
Fax(510) 750-7628
Sole ProprietorYes
Enumeration DateMay 29, 2007
Last NPPES UpdateJune 27, 2012
✔ NPI 1578764403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · MFC 50264
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.
2029 DURANT AVE, Berkeley, CA 94704
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Ms. Kimbo Prichard Ma, Mft has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 2

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

DEANNA MAY LOH AMFT
Marriage & Family Therapist
2029 DURANT AVE
BERKELEY, CA 94704
Alameda County (519) 859-4776
DR. MICHAEL HOWARD MAYER PH.D.
Psychologist (Clinical)
2029 DURANT AVE
BERKELEY, CA 94704
Alameda County (510) 849-2878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimbo Prichard's NPI number?

The NPI number for Kimbo Prichard is 1578764403. It was assigned to this individual provider in the NPPES registry on May 29, 2007.

Where is Kimbo Prichard located?

Kimbo Prichard practices at 2029 Durant Ave #204, Berkeley, CA 94704. The listed phone number is (510) 859-4776.

What is Kimbo Prichard's specialty?

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

Is Kimbo Prichard enrolled in Medicare?

No. Kimbo Prichard has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kimbo Prichard was last updated on June 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.