MEDICARE: KIMBERLY MARIE CASEY

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
1	101YM0800X	Mental Health Counselor
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1275701500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY MARIE CASEY

Provider Business Mailing Address
First Line	:	3780 ROSIN CT STE 110
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95834-1698
Country	:	US
Telephone Number	:	916-441-0226
Fax Number	:

Provider Business Practice Location Address
First Line	:	4433 FLORIN RD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2527
Country	:	US
Telephone Number	:	916-234-2577
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/20/2008
Last Update Date	:	05/23/2022

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Directions to “ KIMBERLY MARIE CASEY ” Practice Location

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