Active NPI
Kimberly Ilvento, PPS
- School Counselor
- South Lake Tahoe, CA
National Provider Identifier
1942010921
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Counselor
- Practice address
- 1735 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-3718 - Phone
- (530) 541-4111
- NPI assigned
- Jan 10, 2025
- 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 |
|---|---|---|---|---|
| School Counselor | 101YS0200X | Primary |
Addresses
Primary practice location
1735 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-3718
Mailing address
1735 Lake Tahoe Blvd
South Lake Tahoe, CA 96150-3718
Phone (530) 541-4111
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736467200000",
"number": "1942010921",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1735 LAKE TAHOE BLVD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961503718",
"telephone_number": "530-541-4111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1735 LAKE TAHOE BLVD",
"city": "SOUTH LAKE TAHOE",
"state": "CA",
"postal_code": "961503718",
"telephone_number": "530-541-4111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ILVENTO",
"first_name": "KIMBERLY",
"credential": "PPS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-10",
"last_updated": "2025-01-10",
"certification_date": "2025-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Lake Tahoe, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.