Miss Kimberly Lyles Butts, is a
Peer Specialist based in San Leandro, California. Miss Kimberly Lyles Butts is licensed to practice in * (Not Available) (license number ) and her current practice location is
545 Estudillo Ave, San Leandro, California. She can be reached at her office (for appointments etc.) via phone at
(510) 352-9200.
NPI number for Miss Kimberly Lyles Butts is 1073099552 and her current mailing address is 1065 A St, Hayward, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1073099552.
Healthcare Provider's Profile
| Full Name | Miss Kimberly Lyles Butts |
|---|
| Gender | Female |
|---|
| Speciality | Peer Specialist |
|---|
| Location | 545 Estudillo Ave, San Leandro, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1073099552
- Provider Enumeration Date: 07/17/2018
- Last Update Date: 02/07/2025
Medical Identifiers
Medical identifiers for Miss Kimberly Lyles Butts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073099552 | NPI | - | NPPES |
| B9627718 | Other | CA | CALIFORNIA ID |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 172V00000X | Community Health Worker | MPSS-MKHLRT (California) | Secondary |
| 175T00000X | Peer Specialist | (* (Not Available)) | Primary |
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. Miss Kimberly Lyles Butts 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 |
|---|
Miss Kimberly Lyles Butts,
1065 A St,
Hayward, CA 94541-4148
Ph: (510) 459-5294 | Miss Kimberly Lyles Butts,
545 Estudillo Ave,
San Leandro, CA 94577-4611
Ph: (510) 352-9200 |
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