Individual provider Active NPI

Kimberly Ann Ciardella, LMFT

  • Marriage & Family Therapist
  • El Dorado Hills, CA
National Provider Identifier
1073804076
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT85413 Issued in CA
Practice address
895 Embarcadero Dr Ste 210
El Dorado Hills, CA 95762-1406
Phone
(916) 538-1683
NPI assigned
Apr 25, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 65133 CA
Marriage & Family Therapist 106H00000X LMFT85413 CA Primary

Addresses

Primary practice location

895 Embarcadero Dr Ste 210
El Dorado Hills, CA 95762-1406

Mailing address

895 Embarcadero Dr Ste 210
El Dorado Hills, CA 95762-1406
Phone (916) 538-1683

Other practice location 1

2750 Sutterville Rd
Sacramento, CA 95820-1024
Phone (916) 290-8138

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
65133CAMDMarriage & Family Therapist
LMFT85413CAMDMarriage & Family Therapist
85413CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Ciardella Therapy & Family Wellness, Inc. Marriage & Family Therapist CurrentSince May 16, 2022 Accepting new patients

Locations

895 Embarcadero Dr
Ste 210
El Dorado Hills, CA 95762
Phone (916) 538-1683

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652313600000",
    "number": "1073804076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "895 EMBARCADERO DR STE 210",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957621406",
            "telephone_number": "916-538-1683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "895 EMBARCADERO DR STE 210",
            "city": "EL DORADO HILLS",
            "state": "CA",
            "postal_code": "957621406",
            "telephone_number": "916-538-1683"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2750 Sutterville Rd",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958201024",
            "country_code": "US",
            "telephone_number": "916-290-8138",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CIARDELLA",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-25",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "65133",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT85413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Dorado Hills, CA

Sources for this page

Verify at the official NPI Registry.