Individual provider Active NPI

Kimberly Liotta Perales, D.C.

  • Chiropractor
  • San Ramon, CA
National Provider Identifier
1922311182
Registry record updated Oct 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC31559 Issued in CA
Practice address
500 Bollinger Canyon Way Ste A15
San Ramon, CA 94582-5297
Phone
(925) 735-8508
Fax
(844) 272-5913
NPI assigned
Jul 16, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC31559 CA Primary

Addresses

Primary practice location

500 Bollinger Canyon Way Ste A15
San Ramon, CA 94582-5297

Mailing address

500 Bollinger Canyon Way Ste A15
San Ramon, CA 94582-5297
Phone (925) 735-8508

Other names 1

  • Dr. Kimberly Ann Liotta Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
31559CAMDClinical Psychologist
DC31559CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Hall Family Chiropractic Inc Chiropractor Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476662400000",
    "number": "1922311182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 BOLLINGER CANYON WAY STE A15",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825297",
            "telephone_number": "925-735-8508",
            "fax_number": "844-272-5913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 BOLLINGER CANYON WAY STE A15",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945825297",
            "telephone_number": "925-735-8508",
            "fax_number": "844-272-5913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERALES",
        "first_name": "KIMBERLY",
        "middle_name": "LIOTTA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2016-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC31559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "LIOTTA",
            "middle_name": "ANN",
            "prefix": "DR.",
            "credential": "D.C.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.