MISS KIMBERLY LYLES BUTTS NPI 1073099552

NPI Information

NPI: 1073099552
Provider Name: MISS KIMBERLY LYLES BUTTS
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
7200 BANCROFT AVE STE 133
OAKLAND, CA
ZIP 94605
Phone: (510) 421-4739
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MISS Kimberly Lyles Butts is a peer specialist in Oakland, CA. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. MISS Kimberly Lyles Butts NPI is 1073099552. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

7200 BANCROFT AVE STE 133
OAKLAND, CA
ZIP 94605-480
Phone: (510) 421-4739

The enumeration date for this NPI number is 7/17/2018 and was last updated on 3/1/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health			No
2	175T00000X	Peer Specialist		MPSS-MKHLRT	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	B9627718	OTHER	CALIFORNIA	CALIFORNIA ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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