Healthcare Provider Details

I. General information

NPI: 1164870812
Provider Name (Legal Business Name): KIARA NA'COLE FROST MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2016
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9340 E STOCKTON BLVD
ELK GROVE CA
95624-1563
US

IV. Provider business mailing address

9340 E STOCKTON BLVD
ELK GROVE CA
95624-1563
US

V. Phone/Fax

Practice location:
  • Phone: 916-509-8198
  • Fax: 916-509-8198
Mailing address:
  • Phone: 916-509-8198
  • Fax: 916-509-8198

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number98383
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: