Kimberly Ann Richardson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

29532 Issued in CA

Practice address

2000 W Briggsmore Ave Ste I
Modesto, CA 95350-3839

Phone

(209) 526-1440

Fax

(209) 526-0908

NPI assigned

Mar 28, 2007

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

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846
  Medicare reassignment

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447804800000",
    "number": "1508985656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1440",
            "fax_number": "209-526-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 W BRIGGSMORE AVE STE I",
            "city": "MODESTO",
            "state": "CA",
            "postal_code": "953503839",
            "telephone_number": "209-526-1440",
            "fax_number": "209-526-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-28",
        "last_updated": "2015-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "29532",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Richards, MD
• Nicole Antionette Renee Richards
• Brian Paul Richardson, MD
• Casey Elizabeth Richardson
• Kathryn Marie Richardson, NP
• Monique Richardson
• Kristofer M Richter, DO (2011)
• Marilyn Ricketts
• Rickey & Wong, D.D.S., Inc.
• Rickey & Wong, DDS, Inc.

• Clinical Social Worker in Modesto, CA
• Providers in Modesto, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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.

Verify at the official NPI Registry.