KIMBERLEE ILISE MATTINGLEY BA SUDCC NPI 1912553702

NPI Information

NPI: 1912553702
Provider Name: KIMBERLEE ILISE MATTINGLEY, BA, SUDCC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3974 DUROCK RD STE 205
SHINGLE SPRINGS, CA
ZIP 95682
Phone: (530) 621-4687
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Kimberlee Ilise Mattingley, BA, SUDCC is an addiction (substance use disorder) counselor in Shingle Springs, CA. Kimberlee Ilise Mattingley, BA, SUDCC NPI is 1912553702. 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:

3974 DUROCK RD STE 205
SHINGLE SPRINGS, CA
ZIP 95682-568
Phone: (530) 621-4687

The enumeration date for this NPI number is 8/16/2019 and was last updated on 10/28/2022.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	10848	CALIFORNIA	Yes

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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