Individual provider Active NPI

Kimberly Trejo, LCSW

  • Clinical Social Worker
  • Clovis, CA
National Provider Identifier
1952664096
Registry record updated Jun 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
28328 Issued in CA
Practice address
255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861
Phone
(559) 297-1300
Fax
(559) 324-7534
NPI assigned
Jun 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 28328 CA Primary

Addresses

Primary practice location

255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861

Mailing address

255 W Bullard Ave
Suite 124
Clovis, CA 93612-0861
Phone (559) 297-1300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20120801000329 CA Practitioner - Clinical Social Worker 3375709652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28328CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reedley Community Hospital CurrentSince Mar 1, 2022 Accepting new patients
Reedley Community Hospital CurrentSince Mar 1, 2022 Accepting new patients

Locations

11976 Road 37
Madera, CA 93636
Phone (559) 645-4191

49063 Road 426
Ste Cd
Oakhurst, CA 93644
Phone (559) 642-1500

372 W Cypress Ave
Reedley, CA 93654
Phone (559) 391-3110

2141 High St
Selma, CA 93662
Phone (559) 856-6110

Organizations & group practices 2

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": "1340323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340323200000",
    "number": "1952664096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE",
            "address_2": "SUITE 124",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-297-1300",
            "fax_number": "559-324-7534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W BULLARD AVE",
            "address_2": "SUITE 124",
            "city": "CLOVIS",
            "state": "CA",
            "postal_code": "936120861",
            "telephone_number": "559-297-1300",
            "fax_number": "559-324-7534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREJO",
        "first_name": "KIMBERLY",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-22",
        "last_updated": "2012-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "28328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clovis, CA

Sources for this page

Verify at the official NPI Registry.