Kimberly Sue Duin, SUDCC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3575 Pershing Ave Apt E
San Diego, CA 92104-3413

Phone

(619) 294-4526

Fax

(619) 294-4526

NPI assigned

Jun 28, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kimberly Sue Kelley Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• New Entra Casa Corporation

  • Substance Abuse Rehabilitation Facility
  • San Diego, CA
  • NPI 1114411386
  NPD

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570060800000",
    "number": "1427543719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3575 PERSHING AVE APT E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043413",
            "telephone_number": "619-294-4526",
            "fax_number": "619-294-4526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 PERSHING AVE APT E",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921043413",
            "telephone_number": "619-294-4526",
            "fax_number": "619-294-4526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUIN",
        "first_name": "KIMBERLY",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "SUDCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2019-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "KELLEY",
            "middle_name": "SUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sally Lynn Dugger
• David Richard Duguid, D.D.S.
• Amina Duh
• Chalesia Duhart
• Lisa Duhaylongsod, M.D.
• Marsha Duka
• Loren Robert Dukate, DO
• Ariana Rose Duke
• Christopher Duke, IDC
• Erik Duke, OTC

• Addiction (Substance Use Disorder) Counselor in San Diego, CA
• Providers in San Diego, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.