KIMBERLY MICHELLE WATERMAN (NPI# 1245861822) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245861822 |
| Entity Type | Individual |
| Full Name | KIMBERLY MICHELLE WATERMAN |
| Practice Address |
505 M St Rio Linda CA 95673-2218 |
| Mailing Address |
5354 J St Sacramento CA 95819-3944 |
| Practice Telephone | 9162874067 |
| Mailing Telephone | 5303052812 |
| Enumeration Date | 2020-01-31 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
505 M ST |
| City | RIO LINDA |
| State | CA |
| Zip Code | 95673-2218 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033402516 | Lisa Ann Mccormic | Counselor | 505 M St, Rio Linda, CA 95673-2218 | 2011-05-17 |
| 1508474289 | Tara Leanne Reynolds | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2020-07-17 |
| 1851917686 | Unmol Joshi | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2020-06-17 |
| 1881234250 | Terri Annette Grace | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2020-01-13 |
| 1073157095 | Chong Neng Thao | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2019-11-02 |
| 1912541392 | Carnita Davenport | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2019-10-29 |
| 1619524899 | Katherine Remhof | Licensed Vocational Nurse | 505 M St, Rio Linda, CA 95673-2218 | 2019-08-21 |
| 1477105328 | Phillisha Love Story | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2019-07-11 |
| 1649736539 | Alexander Ransom | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2019-02-15 |
| 1255895728 | Shelby Nicole Scott | Case Manager/Care Coordinator | 505 M St, Rio Linda, CA 95673-2218 | 2019-01-29 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124191630 | Tamara Juana Isaac Cooksey | Marriage & Family Therapist | 4545 9th Ave, Sacramento, CA 95673 | 2006-11-15 |
| 1316055825 | Michael Tang | Counselor | 7314 W 4th St, Rio Linda, CA 95673-1109 | 2006-08-25 |
| 1578109724 | Wayne Dupree Hunter Jr. | Non-emergency Medical Transport (VAN) | 424 Penn Central Ct, Rio Linda, CA 95673-1474 | 2019-11-22 |
| 1861045056 | James Lovefield | Counselor | 933 Quiet Way, Rio Linda, CA 95673-1520 | 2019-07-17 |
| 1467523829 | County of Sacramento | Clinic/Center | 1040 Q St, Rio Linda, CA 95673-1532 | 2006-11-10 |
| 1760935431 | Alan Hill | Marriage & Family Therapist | 6920 5th Ave, Rio Linda, CA 95673-2209 | 2016-07-29 |
| 1790796324 | Rio Linda Leader Drugs | Pharmacy | 402 M St, Rio Linda, CA 95673-2217 | 2006-08-10 |
| 1568599348 | Bevan Milton Richardson | Dentist | 851 Oak Ln, Rio Linda, CA 95673-2341 | 2007-02-27 |
| 1770085375 | Bevan Richardson | Clinic/Center | 851 Oak Ln, Rio Linda, CA 95673-2341 | 2018-02-28 |
| 1104358209 | Jamie Cantor | Behavior Technician | 7016 22nd St, Rio Linda, CA 95673-2718 | 2017-03-29 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679042477 | Vanessa Monique Hernandez | Student in an Organized Health Care Education/Training Program | 505 M St, Rio Linda, CA 95673-2218 | 2018-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629679741 | Krista Lapidario | Student in an Organized Health Care Education/Training Program | 18602 Kings Row Ave, Cerritos, CA 90703-8048 | 2020-11-04 |
| 1548861818 | Masara Issa | Student in an Organized Health Care Education/Training Program | 2261 Runabout Pl, El Cajon, CA 92019-4250 | 2020-11-03 |
| 1245830736 | Khalid Bey | Student in an Organized Health Care Education/Training Program | 1st Dnbn Attn: Credentials 555221, Camp Pendleton, CA 92055-5221 | 2020-10-26 |
| 1538768221 | Judith Guarneros | Student in an Organized Health Care Education/Training Program | 47 Rogers Rd, Kernville, CA 93238-6021 | 2020-10-22 |
| 1174122048 | Vivian M. Arredondo | Student in an Organized Health Care Education/Training Program | 22656 Lark St, Grand Terrace, CA 92313-5714 | 2020-10-22 |
| 1861091621 | Kristen N Brauchler | Student in an Organized Health Care Education/Training Program | 2098 Cabot Ave, Merced, CA 95348-4023 | 2020-10-22 |
| 1215536206 | Marissa Burton | Student in an Organized Health Care Education/Training Program | 1759 Queenstown Dr, San Jose, CA 95132-1755 | 2020-10-21 |
| 1447859533 | Brooke Edelson | Student in an Organized Health Care Education/Training Program | 21 Waverley Ct Apt 4, Menlo Park, CA 94025-3551 | 2020-10-20 |
| 1891394987 | Shannon Shen | Student in an Organized Health Care Education/Training Program | 190 Ryland St Apt 3422, San Jose, CA 95110-2295 | 2020-10-20 |
| 1164020657 | Corinne Elizabeth Zachry | Student in an Organized Health Care Education/Training Program | 1149 S Hill St # H375, Los Angeles, CA 90015-2212 | 2020-10-15 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.