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

Kristina Akemi Komori

Individual provider Marriage & Family Therapist · NPI 1164871083

Kristina Akemi Komori is a Marriage and Family Therapist in Fullerton, California. Qualified in 2017, 9 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
9
Licensed in
CA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1530 W Olive Ave
Fullerton, CA 92833-3954
Phone: (714) 766-9771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Marriage & Family Therapist (primary) Taxonomy 106H00000X · Licence 132718 (CA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1164871083
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 10, 2016
Last updated in NPPESNovember 1, 2024
Certification dateNovember 1, 2024

Medicare enrollment

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

Medicare specialtyMARRIAGE AND FAMILY THERAPIST
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Fullerton