Kimberly M Holton

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

103819 Issued in CA

Practice address

10630 Town Center Dr Ste 111
Rancho Cucamonga, CA 91730-6888

Phone

(909) 277-3212

NPI assigned

Apr 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kimberly M Holton

  • Clinical Social Worker
  • Rancho Cucamonga, CA
  • NPI 1306526538
  Medicare reassignment NPD Authorized official
• Sud Specialty Group - Ca

  • Addiction Medicine (Psychiatry & Neurology) Physician
  • Santa Clara, CA
  • NPI 1972138238

  Clinical

  Medicare reassignment NPD

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

{
    "created_epoch": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1174057111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5172 ARLINGTON AVE # 4221",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925042686",
            "telephone_number": "951-465-5366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10630 TOWN CENTER DR STE 111",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917306888",
            "telephone_number": "909-277-3212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLTON",
        "first_name": "KIMBERLY",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2023-10-17",
        "certification_date": "2023-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "103819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ruth Allena Holmes, CF-SLP
• Bridjae Holston, ACSW
• Jessica Holt
• Regina S Holt, D.C.
• Caroline Hiroko Holte, PSY.D.
• Home Dialysis Centers of Rancho Cucamonga LLC
• Home Health Care Solutions, Inc.
• Home Health Mastercare Inc
• Home Instead Senior Care
• Home Touch Hospice and Palliative Care, Inc

• Clinical Social Worker in Rancho Cucamonga, CA
• Providers in Rancho Cucamonga, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.