Kimberly Douglass

Primary specialty

Rehabilitation PractitionerTaxonomy code 225400000X

Practice address

2101 Courage Drive
Ms 10-300
Fairfield, CA 94533

Phone

(707) 784-2033

Fax

(707) 425-4014

NPI assigned

Jul 7, 2017

Last updated

Jul 14, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other names 1

• Kimberly Lynn Douglass Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1499385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1962924340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DR # MS 10-300",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "945336717",
            "telephone_number": "707-784-2033",
            "fax_number": "707-425-4014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 COURAGE DRIVE",
            "address_2": "MS 10-300",
            "city": "FAIRFIELD",
            "state": "CA",
            "postal_code": "94533",
            "telephone_number": "707-784-2033",
            "fax_number": "707-425-4014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGLASS",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-07",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "CA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "DOUGLASS",
            "middle_name": "LYNN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Rajinder Singh Dosanjh
• Rokzanne Dosier, FNP-C, RNFA
• Meghan Dotta
• Sean Michael Dougherty, D.P.M.
• Angellique Douglas
• Heather Doumbia
• Moktar Michael Doumbia
• Carleta Dover
• Jade Dovico
• Gloria Ford Doyel, RN, PHN

• Rehabilitation Practitioner in Fairfield, CA
• Providers in Fairfield, CA by specialty
• Rehabilitation Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.

Verify at the official NPI Registry.