Active NPI
Kimberly Borden, MS
- Mental Health Counselor
- Concord, CA
National Provider Identifier
1457928871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 120611
- Practice address
- 4272 Wilson LN
Concord, CA 94521-1263 - Phone
- (925) 381-7477
- NPI assigned
- Jun 4, 2021
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 120611 | CA | Primary |
Addresses
Primary practice location
4272 Wilson LN
Concord, CA 94521-1263
Mailing address
4272 Wilson LN
Concord, CA 94521-1263
Phone (925) 381-7477
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20231106000686 | CA | Order and Referring Only - Other (Non-Physician) | 1456708965 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 120611 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1622764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1622764800000",
"number": "1457928871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4272 WILSON LN",
"city": "CONCORD",
"state": "CA",
"postal_code": "945211263",
"telephone_number": "925-381-7477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4272 WILSON LN",
"city": "CONCORD",
"state": "CA",
"postal_code": "945211263",
"telephone_number": "925-381-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BORDEN",
"first_name": "KIMBERLY",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-06-04",
"last_updated": "2021-06-04",
"certification_date": "2021-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "120611",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Concord, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; 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.