Healthcare Provider Details

I. General information

NPI: 1861585788
Provider Name (Legal Business Name): KIM RAWSON M.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9510 ELK GROVE FLORIN RD
ELK GROVE CA
95624-1801
US

IV. Provider business mailing address

6615 VALLEY HI DRIVE SUITE A
SACRAMENTO CA
95823
US

V. Phone/Fax

Practice location:
  • Phone: 916-769-3083
  • Fax:
Mailing address:
  • Phone: 916-681-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 51332
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number50272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: