Active NPI
Kimberly A Endres, SUDRC
- Addiction (Substance Use Disorder) Counselor
- Redding, CA
National Provider Identifier
1629782826
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 14534
- Practice address
- 1237 California St
Redding, CA 96001-0618 - Phone
- (530) 243-7470
- Fax
- (530) 243-7477
- NPI assigned
- Jan 11, 2023
- 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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 14534 | CA | Primary |
Addresses
Primary practice location
1237 California St
Redding, CA 96001-0618
Mailing address
1237 California St
Redding, CA 96001-0618
Phone (530) 243-7470
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 |
|---|---|---|---|
| 14534 | CA | MD | Registered Respiratory Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1673395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1673395200000",
"number": "1629782826",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1237 CALIFORNIA ST",
"city": "REDDING",
"state": "CA",
"postal_code": "960010618",
"telephone_number": "530-243-7470",
"fax_number": "530-243-7477"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1237 CALIFORNIA ST",
"city": "REDDING",
"state": "CA",
"postal_code": "960010618",
"telephone_number": "530-243-7470",
"fax_number": "530-243-7477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENDRES",
"first_name": "KIMBERLY",
"middle_name": "A",
"credential": "SUDRC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-01-11",
"last_updated": "2023-01-11",
"certification_date": "2023-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "14534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redding, CA
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- Empire Hotel Alcoholic Rehabilitation Center, Inc.
- Empire Hotel Alcoholic Rehabilitation, Inc
- Chloee Engberson
- Michael R Engbretson, M.P.T.
- Ronald Gene England, D.O.
- Jehoisabiah Deleamya Englin, PEER SUPPORT SPECIAL
- Robert John English, DO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.