KEVIN A PHILLIPS SUDRC
NPI 1104532340
Counselor - Addiction (Substance Use Disorder) in Fairfield, CA

Q: What is Kevin Phillips's NPI number?

The NPI number for Kevin Phillips is 1104532340. It was assigned to this individual provider in the NPPES registry on January 30, 2023.

Q: What is Kevin Phillips's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Q: When was this NPI record last updated?

The NPPES record for Kevin Phillips was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.

Active since January 30, 2023

1225 TRAVIS BLVD STE H, FAIRFIELD, CA 94533(707) 399-9190 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Kevin A Phillips Sudrc NPPES

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

KEVIN A PHILLIPS SUDRC (NPI 1104532340) is an individual addiction (substance use disorder) provider in Fairfield, California and active in the NPI registry since January 2023. He maintains a secondary practice location in Fairfield.

NPPES Registry Identity

NPI1104532340

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameKEVIN A PHILLIPSCredential: SUDRC

Location Address1225 TRAVIS BLVD STE HFairfield, CA 94533-4839

Mailing Address609 Jefferson StFairfield, CA 94533-6293 · (707) 399-9190

Phone(707) 399-9190

Sole ProprietorNo

Enumeration DateJanuary 30, 2023

NPPES CertifiedJanuary 30, 2023

✔ NPI 1104532340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

1225 TRAVIS BLVD STE H, Fairfield, CA 94533

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Secondary Practice Location 1

Location 11525 Union AveFairfield, CA 94533-5049 · Phone (916) 759-3023

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. VALERIE MARGARET GODFREY D.D.S.,MS

Dentist (Periodontics)

1225 TRAVIS BLVD STE H
FAIRFIELD, CA 94533

Solano County (707) 429-5201

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 Kevin Phillips's NPI number?

The NPI number for Kevin Phillips is 1104532340. It was assigned to this individual provider in the NPPES registry on January 30, 2023.

Where is Kevin Phillips located?

Kevin Phillips practices at 1225 Travis Blvd Ste H, Fairfield, CA 94533. The listed phone number is (707) 399-9190.

What is Kevin Phillips's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Kevin Phillips was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.