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KIMBERLY HAIRSTON LCSW
NPI 1083784938
Social Worker - Clinical in Ontario, CA

Active since November 08, 2006PECOS EnrolledAccepts Medicare Assignment
4872 S ANDERSON AVE, ONTARIO, CA 91762(213) 706-1359 Get Directions Write a Review

NPPES record last updated: January 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 12, 2026, Nov 30, 2021 (2 updates tracked since 2021).

About Kimberly Hairston Lcsw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY HAIRSTON LCSW (NPI 1083784938) is an individual clinical provider in Ontario, California, licensed in California (21513) and active in the NPI registry since November 2006. She is enrolled in Medicare PECOS and is a graduate of Other (1998).

NPPES Registry Identity

NPI1083784938
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKIMBERLY HAIRSTONCredential: LCSW
Location Address4872 S ANDERSON AVEOntario, CA 91762-7588
Mailing AddressPo Box 6945Norco, CA 92860-8065 · (213) 706-1359
Phone(213) 706-1359
Sole ProprietorNo
Medical School CMSOtherGraduated 1998
Enumeration DateNovember 8, 2006
Last NPPES UpdateJanuary 12, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 12, 2026
✔ NPI 1083784938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
License✔ Licensed in CA · 21513
Definition
A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.
4872 S ANDERSON AVE, Ontario, CA 91762
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kimberly Hairston Lcsw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8325183015
PECOS Enrollment IDI20100305000411
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Hairston reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Sud Specialty Group - Ca
341 mi
Addiction Medicine
4633 OLD IRONSIDES DR STE 304
Santa Clara, CA 95054
  • Reassigned Medicare billing, California enrollment
  • 1,607 clinicians in this Medicare group
NPI 1972138238 (323) 205-7088

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91762 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$0.00 typical visit price
range $59.60 – $179.42
Typical copayment $0.00 (range $14.90 – $44.85)
Most-billed visit code NA
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Hairston's NPI number?

The NPI number for Kimberly Hairston is 1083784938. It was assigned to this individual provider in the NPPES registry on November 8, 2006.

Where is Kimberly Hairston located?

Kimberly Hairston practices at 4872 S Anderson Ave, Ontario, CA 91762. The listed phone number is (213) 706-1359.

What is Kimberly Hairston's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Is Kimberly Hairston enrolled in Medicare?

Yes. Kimberly Hairston is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Kimberly Hairston's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Hairston reassigns Medicare benefits to Sud Specialty Group - Ca (Santa Clara, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Hairston's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kimberly Hairston was last updated on January 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.