Active NPI
Kimberly Michelle Bracone
- Addiction (Substance Use Disorder) Counselor
- Hesperia, CA
National Provider Identifier
1831910090
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- R1597330125
- Practice address
- 11776 Mariposa Rd Ste 103
Hesperia, CA 92345-1622 - Phone
- (760) 987-5368
- NPI assigned
- Oct 21, 2024
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | CA | ||
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | R1597330125 | CA | Primary |
Addresses
Primary practice location
11776 Mariposa Rd Ste 103
Hesperia, CA 92345-1622
Mailing address
11776 Mariposa Rd Ste 103
Hesperia, CA 92345-1622
Phone (760) 987-5368
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 |
|---|---|---|---|
| R1597330125 | 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": "1729468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1745539200000",
"number": "1831910090",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11776 MARIPOSA RD STE 103",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923451622",
"telephone_number": "760-987-5368"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11776 MARIPOSA RD STE 103",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923451622",
"telephone_number": "760-987-5368"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRACONE",
"first_name": "KIMBERLY",
"middle_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-21",
"last_updated": "2025-04-25",
"certification_date": "2025-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "CA",
"license": null,
"primary": false
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "CA",
"license": "R1597330125",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.