Jacquelinne Sudaria, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

51416 Issued in CA

Practice address

400 Mobil Ave.
Suite A1-RC
Camarillo, CA 93010-1044

Phone

(805) 389-4380

Fax

(805) 389-3246

NPI assigned

Feb 26, 2007

Last updated

Jun 10, 2024By the provider in NPPES

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

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacquelinne.sudaria@ventura.cernerdirect.com

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.

• County of Ventura

  dba Ventura County Medical Center

  • General Acute Care Hospital
  • Ventura, CA
  • NPI 1629167457
  Medicare reassignment NPD
• County of Ventura

  dba VCBH - Simi Valley Youth & Family Mental Health

  • Community/Behavioral Health Agency
  • Simi Valley, CA
  • NPI 1609098243
  NPD
• County of Ventura

  • Public Health & General Preventive Medicine Physician
  • Oxnard, CA
  • NPI 1962931477
  NPD

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1972639581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE.",
            "address_2": "SUITE A1-RC",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101044",
            "telephone_number": "805-389-4380",
            "fax_number": "805-389-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MOBIL AVE.",
            "address_2": "SUITE A1-RC",
            "city": "CAMARILLO",
            "state": "CA",
            "postal_code": "930101044",
            "telephone_number": "805-389-4380",
            "fax_number": "805-389-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUDARIA",
        "first_name": "JACQUELINNE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-26",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "51416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jacquelinne.sudaria@ventura.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "Cerner Direct Secure Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Direct Information",
            "address_1": "125 W Thousand Oaks Blvd Ste 300",
            "city": "Thousand Oaks",
            "state": "CA",
            "country_code": "US",
            "postal_code": "913604460",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Robert Cunningham Streeter IV, MD
• Lauren Streiter
• Clinton Strozier
• Kaci Stubblefield
• Matthew Stump
• Roy Isao Sugasawara, MD
• Rebecca Sugawara, MPPD, RD
• Olivia Sugimoto, DMD
• Rita Helene Suley, OTR-L
• Karen Sullivan

• Marriage & Family Therapist in Camarillo, CA
• Providers in Camarillo, 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 Jun 10, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.