Kimberle Rusk Deanda, MA, MFT, BCBA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MFC 47478 Issued in CA

Practice address

260 Maple CT
Ventura, CA 93003-3516

Phone

(805) 323-6174

NPI assigned

Mar 13, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• County of Ventura

  • Community/Behavioral Health Agency
  • Ventura, CA
  • NPI 1386764512
  NPD (past)
• County of Ventura

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1750414256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033516",
            "telephone_number": "805-323-6174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 MAPLE CT",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930033516",
            "telephone_number": "805-323-6174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANDA",
        "first_name": "KIMBERLE",
        "middle_name": "RUSK",
        "credential": "MA, MFT, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-07-24",
        "certification_date": "2023-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "MFT47478",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "BACB525296",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 47478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sierra De Soto
• Jerome De Vera, DO
• Leslie De Vera, PMHNP
• Caroline De Witte
• Dean W. Smith, MD., a Medical Corporation
• Scott Deangelis, OTR/L
• James Ray Deardorff, O.D.
• Natalie Debbas, PPS
• Debon Crews, Optometric Corporation
• Jaime Leigh Debone

• Marriage & Family Therapist in Ventura, CA
• Providers in Ventura, 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 Jul 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.