Kimberly Fanning-Shiles, LMFT
NPI 1063867737ActiveIndividual· Marriage & Family Therapist· Rancho Cucamonga, CA
Marriage & Family Therapist (LMFT) with Sud Specialty Group - Ca, practicing in Rancho Cucamonga, California. Enrolled in Medicare as practitioner - marriage and family therapist.
Overview
| NPI | 1063867737 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | LMFT |
| Sole proprietor | Yes |
| NPI issued | Apr 29, 2016 |
| Last updated in NPPES | Jul 17, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Marriage & Family Therapist Primary | 106H00000X | 98512 | CA |
| Counselor, Mental Health | 101YM0800X | IMF 80277 | CA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Marriage and Family Therapist (CA) |
|---|
Education and affiliations
| Graduation year | 2014 |
|---|---|
| Medicare specialty | Marriage And Family Therapist |
Medical group
- Sud Specialty Group - CaSanta Clara, CA · 568 clinicians
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