Kimberly Douglass, is a
Rehabilitation Practitioner based in Fairfield, California. Kimberly Douglass is licensed to practice in * (Not Available) (license number ) and her current practice location is
2101 Courage Drive, Ms 10-300, Fairfield, California. She can be reached at her office (for appointments etc.) via phone at
(707) 784-2033.
NPI number for Kimberly Douglass is 1962924340 and her current mailing address is 2101 Courage Dr # Ms 10-300, Fairfield, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1962924340.
Healthcare Provider's Profile
| Full Name | Kimberly Douglass |
|---|
| Gender | Female |
|---|
| Speciality | Rehabilitation Practitioner |
|---|
| Location | 2101 Courage Drive, Fairfield, California |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1962924340
- Provider Enumeration Date: 07/07/2017
- Last Update Date: 07/14/2025
Medical Identifiers
Medical identifiers for Kimberly Douglass such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962924340 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
| 171M00000X | Case Manager/care Coordinator | (California) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kimberly Douglass is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kimberly Douglass,
2101 Courage Dr # Ms 10-300,
Fairfield, CA 94533-6717
Ph: (707) 784-2033 | Kimberly Douglass,
2101 Courage Drive, Ms 10-300,
Fairfield, CA 94533
Ph: (707) 784-2033 |
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