Kandi Martel Dudley

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

47408 Issued in CA

Practice address

17215 Studebaker Rd
Suite 110
Cerritos, CA 90703-2548

Phone

(323) 547-8977

NPI assigned

Mar 30, 2007

Reactivated

May 25, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Marriage and Family Therapist

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sud Specialty Group - CaGroup PAC ID 9537534177, 519 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Sud Specialty Group - Ca

  dba Rula Health

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1194845453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1336 SINGINGWOOD AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917674114",
            "telephone_number": "323-547-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17215 STUDEBAKER RD",
            "address_2": "SUITE 110",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907032548",
            "telephone_number": "323-547-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUDLEY",
        "first_name": "KANDI",
        "middle_name": "MARTEL",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "deactivation_date": "2020-10-16",
        "reactivation_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "47408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Sheldon B Pitluk, Optometrist, PC
• Dr. Bhavin. S Gandhi DDS Inc
• Dr. S. Kent Choi, Inc.
• Dr. Toan D Nguyen, D.D.S., Inc.
• Jorge Dubin, MD
• Emma Duenas
• Joline Emily Duenas
• Marlon Duenas
• Ricky Dumpit, MS CCC-SLP
• Khanh Duong, BI

• Marriage & Family Therapist in Cerritos, CA
• Providers in Cerritos, 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 May 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.