Kimberlee Ilise Mattingley, BA, SUDCC is a
Counselor - Addiction (substance Use Disorder) based in Shingle Springs, California. Kimberlee Ilise Mattingley is licensed to practice in California (license number 10848) and her current practice location is
3974 Durock Rd Ste 205, Shingle Springs, California. She can be reached at her office (for appointments etc.) via phone at
(530) 621-4687.
NPI number for Kimberlee Ilise Mattingley is 1912553702 and her current mailing address is 3974 Durock Rd Ste 205, Shingle Springs, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1912553702.
Healthcare Provider's Profile
| Full Name | Kimberlee Ilise Mattingley |
|---|
| Gender | Female |
|---|
| Speciality | Counselor - Addiction (substance Use Disorder) |
|---|
| Location | 3974 Durock Rd Ste 205, Shingle Springs, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1912553702
- Provider Enumeration Date: 08/16/2019
- Last Update Date: 10/28/2022
Medical Identifiers
Medical identifiers for Kimberlee Ilise Mattingley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1912553702 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 10848 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberlee Ilise Mattingley is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberlee Ilise Mattingley, BA, SUDCC
3974 Durock Rd Ste 205,
Shingle Springs, CA 95682-8568
Ph: (530) 621-4687 | Kimberlee Ilise Mattingley, BA, SUDCC
3974 Durock Rd Ste 205,
Shingle Springs, CA 95682-8568
Ph: (530) 621-4687 |
Reviews and Comments