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MR. KELLY GENE COBURN LMFT
NPI 1750633970
Marriage & Family Therapist in Santa Ana, CA

Active since October 11, 2012PECOS Enrolled
401 W CIVIC CENTER DR STE 600, SANTA ANA, CA 92701(714) 850-8405 Get Directions Write a Review

NPPES record last updated: May 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2021, Nov 27, 2019, Mar 23, 2017 (3 updates tracked since 2017).

About Mr. Kelly Gene Coburn Lmft NPPES

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

MR. KELLY GENE COBURN LMFT (NPI 1750633970) is an individual marriage & family therapist in Santa Ana, California, licensed in California (112266) and active in the NPI registry since October 2012. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750633970
Entity TypeIndividualMale
Primary Taxonomy106H00000X
Provider Legal NameMR. KELLY GENE COBURNCredential: LMFT
Location Address401 W CIVIC CENTER DR STE 600Santa Ana, CA 92701-4515
Mailing Address2035 E Ball Rd, Ste. 100-aAnaheim, CA 92806-5159 · (714) 517-6152
Phone(714) 850-8405
Sole ProprietorYes
Enumeration DateOctober 11, 2012
Last NPPES UpdateMay 26, 20213 updates tracked since enumeration
NPPES CertifiedMay 26, 2021
✔ NPI 1750633970 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 · 112266
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.
401 W CIVIC CENTER DR STE 600, Santa Ana, CA 92701
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Kelly Gene Coburn Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 2

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

MS. KELLIE BOUGARD -JORDAN
Counselor (Professional)
401 W CIVIC CENTER DR STE 600
SANTA ANA, CA 92701
Orange County (714) 480-6767
GISELA MARIA OBIETA VILLAVICENCIO LCSW
Social Worker (Clinical)
401 W CIVIC CENTER DR STE 600
SANTA ANA, CA 92701
Orange County (714) 850-8402

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 Kelly Coburn's NPI number?

The NPI number for Kelly Coburn is 1750633970. It was assigned to this individual provider in the NPPES registry on October 11, 2012.

Where is Kelly Coburn located?

Kelly Coburn practices at 401 W Civic Center Dr Ste 600, Santa Ana, CA 92701. The listed phone number is (714) 850-8405.

What is Kelly Coburn's specialty?

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

Is Kelly Coburn enrolled in Medicare?

Yes. Kelly Coburn is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Coburn was last updated on May 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.