KIMBERLEE ILISE MATTINGLEY BA, SUDCC
NPI 1912553702
Counselor - Addiction (Substance Use Disorder) in Shingle Springs, CA

Q: What is Kimberlee Mattingley's NPI number?

The NPI number for Kimberlee Mattingley is 1912553702. It was assigned to this individual provider in the NPPES registry on August 16, 2019.

Q: What is Kimberlee Mattingley's specialty?

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

Active since August 16, 2019

3974 DUROCK RD STE 205, SHINGLE SPRINGS, CA 95682(530) 621-4687 Get Directions Write a Review

NPPES record last updated: October 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Oct 28, 2022, Jun 23, 2020, May 27, 2020 and 1 more (4 updates tracked since 2019).

On this page

About Kimberlee Ilise Mattingley Ba, Sudcc NPPES

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

KIMBERLEE ILISE MATTINGLEY BA, SUDCC (NPI 1912553702) is an individual addiction (substance use disorder) provider in Shingle Springs, California, licensed in California (10848) and active in the NPI registry since August 2019.

NPPES Registry Identity

NPI1912553702

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameKIMBERLEE ILISE MATTINGLEYCredential: BA, SUDCC

Location Address3974 DUROCK RD STE 205Shingle Springs, CA 95682-8568

Mailing Address3974 Durock Rd Ste 205Shingle Springs, CA 95682-8568 · (530) 621-4687

Phone(530) 621-4687

Sole ProprietorNo

Enumeration DateAugust 16, 2019

Last NPPES UpdateOctober 28, 20224 updates tracked since enumeration

NPPES CertifiedOctober 28, 2022

✔ NPI 1912553702 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

License✔ Licensed in CA · 10848

3974 DUROCK RD STE 205, Shingle Springs, CA 95682

Open in Google Maps ↗

Other Providers at the Same Location NPPES

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

COUNTY OF EL DORADO

Community/Behavioral Health

3974 DUROCK RD STE 205
SHINGLE SPRINGS, CA 95682

El Dorado County (530) 621-6659

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 Kimberlee Mattingley's NPI number?

The NPI number for Kimberlee Mattingley is 1912553702. It was assigned to this individual provider in the NPPES registry on August 16, 2019.

Where is Kimberlee Mattingley located?

Kimberlee Mattingley practices at 3974 Durock Rd Ste 205, Shingle Springs, CA 95682. The listed phone number is (530) 621-4687.

What is Kimberlee Mattingley'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 Kimberlee Mattingley was last updated on October 28, 2022. 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.