Ronald Kimball

Individual provider Active NPI Rehabilitation Practitioner · Greenville, CA

NPI 1992075147 · NPPES record last updated Jan 5, 2012

Key facts

NPI
1992075147
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
License
GF-125399361-050 (NV)
Practice address
312 Crescent St
Greenville, CA 95947
Phone
(530) 284-7007
Fax
(530) 284-7111
NPI assigned
Jan 5, 2012
Sex
Male
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
GF-125399361-050NVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Circle Family Services Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X GF-125399361-050 NV Yes

Addresses

Primary practice location

312 Crescent St
Greenville, CA 95947

Mailing address

PO Box 554
Greenville, CA 95947-0554
Phone (530) 284-7007

Other providers in Greenville, CA

All providers in Greenville, CA · Rehabilitation Practitioner in California

Sources for this page

Verify at the official NPI Registry.