Charlisse Kinney

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

700 Riverlake Way
Sacramento, CA 95831-1125

Phone

(916) 521-7347

NPI assigned

Oct 6, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1633478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1245992387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6400 TUPELO DR",
            "city": "CITRUS HEIGHTS",
            "state": "CA",
            "postal_code": "956211741",
            "telephone_number": "916-729-3098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 RIVERLAKE WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958311125",
            "telephone_number": "916-521-7347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KINNEY",
        "first_name": "CHARLISSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-10-06",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gagandeep K Kingra, N.P.
• George Jerome Kingsley, D.D.S.
• Tara Marie Kingsley
• Carissa Ann Kiniery
• Lisa Marie Kinnebrew
• Walter K. Kinney, MD
• Amber Kinnier, OTD, OTR/L
• Donna Jean Kinser, MD
• Karley Dawn Kinsey, RN, OCN
• Nissma Mahmoud Eldeeb Kinsey, PA-C

• Behavior Technician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Behavior Technician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.