Healthcare Provider Details

I. General information

NPI: 1619223534
Provider Name (Legal Business Name): KATHY YIMER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2012
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1014 RILEY ST STE 5
FOLSOM CA
95630-3264
US

IV. Provider business mailing address

1014 RILEY ST STE 5
FOLSOM CA
95630-3264
US

V. Phone/Fax

Practice location:
  • Phone: 530-724-6269
  • Fax: 530-237-0454
Mailing address:
  • Phone: 530-724-6269
  • Fax: 530-237-0454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number0439201
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number135515
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: