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NPI Code Detail

MEDICARE: MRS. KIMBERLY ANN SMITH MS, CCC-SLP

MEDICARE: MRS. KIMBERLY ANN SMITH MS, CCC-SLP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1235Z00000XSpeech-Language Pathologist18075CA

General Provider Information

NPI Number : 1255672788
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMBERLY ANN SMITH MS, CCC-SLP
Provider Business Mailing Address
First Line : 2741 RIVERSIDE BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-2900
Country : US
Telephone Number : 916-426-6005
Fax Number : 916-426-6005
Provider Business Practice Location Address
First Line : 2741 RIVERSIDE BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-2900
Country : US
Telephone Number : 916-426-6005
Fax Number : 916-426-6005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2013
Last Update Date : 05/12/2026

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Directions to “ MRS. KIMBERLY ANN SMITH MS, CCC-SLP” Practice Location

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