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KIMBERLY ANN MEDINA MFT
NPI 1922568419
Marriage & Family Therapist in Dublin, CA

Active since March 21, 2019PECOS Enrolled
5325 BRODER BLVD, DUBLIN, CA 94568(925) 551-6500 Get Directions Write a Review

NPPES record last updated: February 11, 2022. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 11, 2022, Mar 21, 2019 (2 updates tracked since 2019).

About Kimberly Ann Medina Mft NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY ANN MEDINA MFT (NPI 1922568419) is an individual marriage & family therapist in Dublin, California, licensed in California (45593) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1922568419
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKIMBERLY ANN MEDINACredential: MFT
Location Address5325 BRODER BLVDDublin, CA 94568-3309
Mailing Address5325 Broder BlvdDublin, CA 94568-3309
Phone(925) 551-6500
Sole ProprietorYes
Enumeration DateMarch 21, 2019
Last NPPES UpdateFebruary 11, 20222 updates tracked since enumeration
✔ NPI 1922568419 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 45593
Definition
A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.
5325 BRODER BLVD, Dublin, CA 94568
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kimberly Ann Medina Mft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Medina reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
24 mi
Internal Medicine
1190 VETERANS BLVD
Redwood City, CA 94063
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1639252604 (650) 299-2000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANTOINETTE TAYLOR
Social Worker (Clinical)
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6500
STUART KOSH
Social Worker
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (209) 843-0285
HOMAYUN SALEH
Physician Assistant
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6701
TOBY EVANS
Community Health Worker
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6500
JASMINE HARDISON
Day Training/Habilitation Specialist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6740
SVETLANA LESOVA LMFT
Marriage & Family Therapist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-5009
MS. MARIANA TORRES M.S.W.
Social Worker (Clinical)
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6740
KATELYN TSUKAMAKI
Marriage & Family Therapist
5325 BRODER BLVD
DUBLIN, CA 94568
Alameda County (925) 551-6905

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Medina's NPI number?

The NPI number for Kimberly Medina is 1922568419. It was assigned to this individual provider in the NPPES registry on March 21, 2019.

Where is Kimberly Medina located?

Kimberly Medina practices at 5325 Broder Blvd, Dublin, CA 94568. The listed phone number is (925) 551-6500.

What is Kimberly Medina's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Is Kimberly Medina enrolled in Medicare?

Yes. Kimberly Medina is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Medina's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Medina reassigns Medicare benefits to Permanente Medical Group Inc (Redwood City, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Medina's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Medina was last updated on February 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.