1. Home
  2. Directory
  3. California
  4. Kelseyville
  5. Marriage Family Therapist
  6. NPI Profile
Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KATHERINE LYNN KISNER
NPI 1649745423
Marriage & Family Therapist in Kelseyville, CA

Active since October 09, 2018PECOS Enrolled
4655 HAWAINA WAY, KELSEYVILLE, CA 95451(714) 357-2602 Get Directions Write a Review

NPPES record last updated: October 21, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Apr 4, 2025, Jan 3, 2023, Jan 5, 2022 and 3 more (6 updates tracked since 2018).

About Katherine Lynn Kisner NPPES

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

KATHERINE LYNN KISNER (NPI 1649745423) is an individual marriage & family therapist in Kelseyville, California, licensed in California (154064) and active in the NPI registry since October 2018. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1649745423
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKATHERINE LYNN KISNER
Location Address4655 HAWAINA WAYKelseyville, CA 95451-9757
Mailing AddressPo Box 61Kelseyville, CA 95451-0061
Phone(714) 357-2602
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 9, 2018
Last NPPES UpdateOctober 21, 20266 updates tracked since enumeration
NPPES CertifiedOctober 21, 2026
✔ NPI 1649745423 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 · 154064
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.
4655 HAWAINA WAY, Kelseyville, CA 95451
Open in Google Maps ↗

Other Names 1

Former Name (1)Katherine Lynn Stratton

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Katherine Lynn Kisner is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1557835790
PECOS Enrollment IDI20260630000014
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.

Medicare Billing Reassignment

Medicare enrollment records show Katherine Kisner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Shine Medical Of Ca PC
121 mi
Psychiatry
325 S 1ST ST STE 200
San Jose, CA 95113
  • Reassigned Medicare billing, California enrollment
  • 45 clinicians in this Medicare group
NPI 1942935473 (888) 380-2028

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Katherine Kisner's NPI number?

The NPI number for Katherine Kisner is 1649745423. It was assigned to this individual provider in the NPPES registry on October 9, 2018. The provider is also known as Katherine Lynn Stratton.

Where is Katherine Kisner located?

Katherine Kisner practices at 4655 Hawaina Way, Kelseyville, CA 95451. The listed phone number is (714) 357-2602.

What is Katherine Kisner's specialty?

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

Is Katherine Kisner enrolled in Medicare?

Yes. Katherine Kisner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katherine Kisner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Kisner reassigns Medicare benefits to Shine Medical Of Ca PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Katherine Kisner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Katherine Kisner was last updated on October 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 days 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.