Active NPI
Kimberly Nelson Homeniuk, PHD
- Mental Health Counselor
- San Francisco, CA
National Provider Identifier
1043892995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 76851
- Practice address
- 650 5TH St Ste 405
San Francisco, CA 94107-1541 - Phone
- (415) 231-5333
- Fax
- (415) 231-5332
- NPI assigned
- Apr 21, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 76851 | TX | Primary |
Addresses
Primary practice location
650 5TH St Ste 405
San Francisco, CA 94107-1541
Mailing address
14329 Geronimo
Leander, TX 78641-9698
Phone (512) 745-7598
Other names 1
- Dr. Kimberly Nelson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76851 | TX | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1043892995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14329 GERONIMO",
"city": "LEANDER",
"state": "TX",
"postal_code": "786419698",
"telephone_number": "512-745-7598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "650 5TH ST STE 405",
"city": "SAN FRANCISCO",
"state": "CA",
"postal_code": "941071541",
"telephone_number": "415-231-5333",
"fax_number": "415-231-5332"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOMENIUK",
"first_name": "KIMBERLY",
"middle_name": "NELSON",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-21",
"last_updated": "2021-04-21",
"certification_date": "2021-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "76851",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "NELSON",
"prefix": "DR.",
"credential": "PHD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in San Francisco, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.