Healthcare Provider Details

I. General information

NPI: 1679724173
Provider Name (Legal Business Name): YASHICA W BUDDE LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2008
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 SHASTA WAY STE C
SIMI VALLEY CA
93065-1858
US

IV. Provider business mailing address

1014 S WESTLAKE BLVD STE 14-362
WESTLAKE VILLAGE CA
91361-3108
US

V. Phone/Fax

Practice location:
  • Phone: 818-807-6274
  • Fax: 805-285-0545
Mailing address:
  • Phone: 818-807-6274
  • Fax: 805-285-0545

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number54019
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: