Kimberly Dirks Panganiban, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC52717 Issued in CA

Practice address

16935 W Bernardo Dr
Suite 208
San Diego, CA 92127-1634

Phone

(858) 361-6016

Fax

(858) 451-0333

NPI assigned

Dec 15, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Ms. Kimberly Michelle Dirks Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 11, 2024 through Jan 11, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Panganiban Marriage and Family Therapy Inc.

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1376260471
  NPD Authorized official

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1154483816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16935 W BERNARDO DR",
            "address_2": "SUITE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271634",
            "telephone_number": "858-361-6016",
            "fax_number": "858-451-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16935 W BERNARDO DR",
            "address_2": "SUITE 208",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921271634",
            "telephone_number": "858-361-6016",
            "fax_number": "858-451-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGANIBAN",
        "first_name": "KIMBERLY",
        "middle_name": "DIRKS",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "54218",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC52717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDI-CAL PROVIDER NUMBER",
            "identifier": "9613",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DIRKS",
            "middle_name": "MICHELLE",
            "prefix": "MS.",
            "credential": "IMF",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leanne Pang, RN
• Lon Kai Pang, MD MBA
• Emilie A Pangan, PTA
• Joseph Pangan
• Panganiban Marriage and Family Therapy Inc.
• Maia Jisel Pangelinan
• Edgardo Alfaro Pangilinan, CRT,RRT(R)
• Nilda Magpili Pangilinan
• Roderick Fajardo Pangilinan
• Monique Shydell Paniagua

• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.