Healthcare Provider Details

I. General information

NPI: 1275260077
Provider Name (Legal Business Name): WILLIAM KLEEMANN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

192 BITTERCREEK DR
FOLSOM CA
95630-2307
US

IV. Provider business mailing address

192 BITTERCREEK DR
FOLSOM CA
95630-2307
US

V. Phone/Fax

Practice location:
  • Phone: 916-337-7504
  • Fax:
Mailing address:
  • Phone: 916-337-7504
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberASW109169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: