Active NPI
Kimberly S Hollingsworth, MFT, NCC
- Marriage & Family Therapist
- Fresno, CA
National Provider Identifier
1407915465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFT 34980
- Practice address
- 4785 N 1St St
Second Floor
Fresno, CA 93726-0513 - Phone
- (559) 448-4012
- Fax
- (559) 448-4867
- NPI assigned
- Dec 6, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | NCC 44057 | ||
| Marriage & Family Therapist | 106H00000X | MFT 34980 | CA | Primary |
Addresses
Primary practice location
4785 N 1St St
Second Floor
Fresno, CA 93726-0513
Mailing address
4785 N 1St St
Second Floor
Fresno, CA 93726-0513
Phone (559) 448-4012
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq | Health Information Exchange (HIE) | The Permanente Medical Group |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFT 34980 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640822400000",
"number": "1407915465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4785 N 1ST ST",
"address_2": "SECOND FLOOR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937260513",
"telephone_number": "559-448-4012",
"fax_number": "559-448-4867"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4785 N 1ST ST",
"address_2": "SECOND FLOOR",
"city": "FRESNO",
"state": "CA",
"postal_code": "937260513",
"telephone_number": "559-448-4012",
"fax_number": "559-448-4867"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLLINGSWORTH",
"first_name": "KIMBERLY",
"middle_name": "S",
"name_prefix": "Ms.",
"credential": "MFT, NCC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-06",
"last_updated": "2021-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": "NCC 44057",
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFT 34980",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
"affiliation": "Y",
"endpointDescription": "Carequality",
"affiliationName": "The Permanente Medical Group",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "C-CDA",
"address_1": "4785 N 1st St",
"city": "Fresno",
"state": "CA",
"country_code": "US",
"postal_code": "937260513",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 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.