Individual provider Active NPI

Kundara Varman Ou

  • Marriage & Family Therapist
  • Ceres, CA
National Provider Identifier
1194853994
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT104476 Issued in CA
Practice address
1904 Richland Ave
Ceres, CA 95307-4562
Phone
(209) 558-4420
Fax
(209) 558-4586
NPI assigned
Mar 1, 2007
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT104476 CA Primary

Addresses

Primary practice location

1904 Richland Ave
Ceres, CA 95307-4562

Mailing address

1904 Richland Ave
Ceres, CA 95307
Phone (209) 558-4600

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240515003698 CA Practitioner - Marriage and Family Therapist 4981045317 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LMFT104476CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
County of Stanislaus CurrentSince Apr 3, 2024 Accepting new patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Apr 3, 2024 Accepting new patients
County of Stanislaus Current Accepting new patients
County of Stanislaus CurrentSince Apr 3, 2024 Accepting new patients

Locations

1904 Richland Ave
Ceres, CA 95307
Phone (209) 525-7411

1904 Richland Ave
Bldg F
Ceres, CA 95307
Phone (209) 525-7444

500 N 9th St
Ste A
Modesto, CA 95350
Phone (209) 525-5300

500 N 9th St
Ste B
Modesto, CA 95350
Phone (209) 341-1824

2101 Geer Rd
Ste 120
Turlock, CA 95382
Phone (209) 558-4598

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1194853994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1904 RICHLAND AVE",
            "city": "CERES",
            "state": "CA",
            "postal_code": "95307",
            "telephone_number": "209-558-4600",
            "fax_number": "209-541-2549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 RICHLAND AVE",
            "city": "CERES",
            "state": "CA",
            "postal_code": "953074562",
            "telephone_number": "209-558-4420",
            "fax_number": "209-558-4586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OU",
        "first_name": "KUNDARA",
        "middle_name": "VARMAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT104476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ceres, CA

Sources for this page

Verify at the official NPI Registry.