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KIMBERLY RICHARDSON
NPI 1306194543
Social Worker - Clinical in Roseville, CA

Active since August 20, 2012PECOS Enrolled
1911 DOUGLAS BLVD # 85-408, ROSEVILLE, CA 95661(626) 824-9855 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kimberly Richardson NPPES

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

KIMBERLY RICHARDSON (NPI 1306194543) is an individual clinical provider in Roseville, California, licensed in California (28670) and active in the NPI registry since August 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1306194543
Entity TypeIndividualFemale
Primary Taxonomy1041C0700X
Provider Legal NameKIMBERLY RICHARDSON
Location Address1911 DOUGLAS BLVD # 85-408Roseville, CA 95661-3811
Mailing Address1911 Douglas Blvd # 85-408Roseville, CA 95661-3811
Phone(626) 824-9855
Sole ProprietorYes
Enumeration DateAugust 20, 2012
Last NPPES UpdateAugust 11, 2022
NPPES CertifiedAugust 11, 2022
✔ NPI 1306194543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Licenses✔ Licensed in CA · 28670✔ Licensed in LA · 5925
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.
1911 DOUGLAS BLVD # 85-408, Roseville, CA 95661
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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 (PECOS)

Kimberly Richardson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Richardson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cyti Health PC
475 mi
Mental Health (Including Community Mental Health Center)
402 W BROADWAY STE 400
San Diego, CA 92101
  • Reassigned Medicare billing, California enrollment
  • 545 clinicians in this Medicare group
NPI 1679172290 (866) 478-3978

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 95661 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 $60.44 – $180.85
Typical copayment $0.00 (range $15.11 – $45.21)
Most-billed visit code NA
Established Patient
$75.03 typical visit price
range $19.88 – $148.15
Typical copayment $18.75 (range $4.97 – $37.03)
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 Richardson's NPI number?

The NPI number for Kimberly Richardson is 1306194543. It was assigned to this individual provider in the NPPES registry on August 20, 2012.

Where is Kimberly Richardson located?

Kimberly Richardson practices at 1911 Douglas Blvd # 85-408, Roseville, CA 95661. The listed phone number is (626) 824-9855.

What is Kimberly Richardson's specialty?

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

Is Kimberly Richardson enrolled in Medicare?

Yes. Kimberly Richardson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Richardson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Richardson reassigns Medicare benefits to Cyti Health PC (San Diego, 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 Richardson'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 Richardson was last updated on August 11, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.