Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kathleen Baniwas, LMFT

Individual provider Marriage & Family Therapist · NPI 1710339650

Kathleen Baniwas, LMFT is a Marriage and Family Therapist in Vista, California. Qualified in 2015, 11 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2016
Specialties on file
2
What do these letters mean?
LMFT — Licensed Marriage and Family Therapist
A therapist licensed to treat couples and families.

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Practice location Address checks out

780 Shadowridge Dr
Vista, CA 92083-7986
Phone: (760) 599-2471
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 107813 (CA)
Marriage & Family Therapist Taxonomy 106H00000X · Licence IMF89556 (CA)

Record details

NPI number1710339650
Entity typeIndividual (Type 1)
GenderFemale
Credentials LMFT
Sole proprietorNo
NPI enumeratedJuly 4, 2016
Last updated in NPPESNovember 19, 2021
Certification dateNovember 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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