Kimberly Lauren Broussard

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

242 N Villa Ave
Willows, CA 95988-2641

Phone

(530) 934-6582

NPI assigned

Jun 22, 2022

Last updated

Sep 9, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Interoperability endpoints

• Direct secure messaging: kbroussard@countyoflgenn.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1073244752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N VILLA AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882641",
            "telephone_number": "530-934-6582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N VILLA AVE",
            "city": "WILLOWS",
            "state": "CA",
            "postal_code": "959882641",
            "telephone_number": "530-934-6582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUSSARD",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-06-22",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kbroussard@countyoflgenn.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "242 N Villa Ave",
            "city": "Willows",
            "state": "CA",
            "country_code": "US",
            "postal_code": "959882641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anne Frances Bonesio, RPH
• Braydon Bouwhuis
• William Boyes, FNP-BC
• Marc Steven Bracy, MD
• Dedra Ann Brooks, LCSW
• Shelby Rae Bruce
• Maxwel Joseph Bryant
• Denbeigh Lee Burgess
• Jose Alejandro Calderon, B.A.
• California Em-I Medical Services a Medical Corporation

• Rehabilitation Practitioner in Willows, CA
• Providers in Willows, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.