Active NPI
Michael L. Kimbarow, PH.D.
- Speech-Language Pathologist
- San Mateo, CA
National Provider Identifier
1467455733
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 11612
- Practice address
- 3409 Allison CT
San Mateo, CA 94403-3953 - Phone
- (650) 572-1494
- Fax
- (650) 345-5860
- NPI assigned
- May 31, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 11612 | CA | Primary |
Addresses
Primary practice location
3409 Allison CT
San Mateo, CA 94403-3953
Mailing address
3409 Allison CT
San Mateo, CA 94403-3953
Phone (650) 572-1494
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11612 | CA | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1467455733",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3409 ALLISON CT",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944033953",
"telephone_number": "650-572-1494",
"fax_number": "650-345-5860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3409 ALLISON CT",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944033953",
"telephone_number": "650-572-1494",
"fax_number": "650-345-5860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBAROW",
"first_name": "MICHAEL",
"middle_name": "L.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-31",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "11612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Mateo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.