MISS KIMBERLY LYLES BUTTS NPI 1073099552

NPI Information

  • NPI: 1073099552
  • Provider Name: MISS KIMBERLY LYLES BUTTS
  • Classification: Peer Specialist - 175T00000X
  • Entity Type: Individual
  • Address: 545 ESTUDILLO AVE
    SAN LEANDRO, CA
    ZIP 94577
  • Phone: (510) 352-9200

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NPI Details

MISS Kimberly Lyles Butts is a peer specialist in San Leandro, 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:

545 ESTUDILLO AVE
SAN LEANDRO, CA
ZIP 94577-611
Phone: (510) 352-9200

The enumeration date for this NPI number is 7/17/2018 and was last updated on 2/7/2025.

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
1101YM0800XCounselorMental HealthNo
2172V00000XCommunity Health WorkerMPSS-MKHLRTCALIFORNIANo
3175T00000XPeer SpecialistYes

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
1B9627718OTHERCALIFORNIACALIFORNIA 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: 11/21/2025

NPI Synchronization or Removal

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