Active NPI
Kimberly Kay Buksa, MA
- Marriage & Family Therapist
- Petaluma, CA
National Provider Identifier
1750699591
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 92609
- Practice address
- 5 Keller St
Suite D
Petaluma, CA 94952-2349 - Phone
- (707) 776-6414
- NPI assigned
- Sep 14, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 92609 | CA | Primary |
Addresses
Primary practice location
5 Keller St
Suite D
Petaluma, CA 94952-2349
Mailing address
314 Bond Ave
Petaluma, CA 94954-5647
Phone (415) 623-9514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 92609 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1284422400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1750699591",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "314 BOND AVE",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949545647",
"telephone_number": "415-623-9514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 KELLER ST",
"address_2": "SUITE D",
"city": "PETALUMA",
"state": "CA",
"postal_code": "949522349",
"telephone_number": "707-776-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUKSA",
"first_name": "KIMBERLY",
"middle_name": "KAY",
"credential": "MA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-09-14",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "92609",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Petaluma, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.