Individual provider Active NPI

Kimberly Suzanne Taylor

  • Clinical Social Worker
  • San Francisco, CA
National Provider Identifier
1154750164
Registry record updated May 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
76821 Issued in CA
Practice address
972 Mission St
San Francisco, CA 94103-2931
Phone
(415) 714-3422
NPI assigned
Nov 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Social Worker 104100000X 61501 CA
Clinical Social Worker 1041C0700X 61501 CA
Clinical Social Worker 1041C0700X 76821 CA Primary

Addresses

Primary practice location

972 Mission St
San Francisco, CA 94103-2931

Mailing address

972 Mission St
San Francisco, CA 94103-2931
Phone (415) 714-3422

Other names 1

  • Kimberly Carl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260605003022 CA Practitioner - Clinical Social Worker 9436620804 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Los Angeles, CA 90074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
76821CAMDClinical Social Worker
61501CAMDDentist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748476800000",
    "number": "1154750164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032931",
            "telephone_number": "415-714-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 MISSION ST",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941032931",
            "telephone_number": "415-714-3422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KIMBERLY",
        "middle_name": "SUZANNE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-11",
        "last_updated": "2025-05-29",
        "certification_date": "2025-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "61501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "61501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "76821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "CARL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.