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Miss Kimberly Lyles Butts
Peer Specialist in Oakland, California
NPI 1073099552

Kimberly Lyles Butts is a Peer Specialist based in Oakland, CA. Kimberly Lyles Butts practices in Oakland, CA. The NPI Number for Kimberly Lyles Butts is 1073099552 and holds a License No. (California).

The current practice location address for Kimberly Lyles Butts is 7200 Bancroft Ave Ste 133, Oakland, CA and can be reached out via phone at 510-421-4739.

Location: 7200 Bancroft Ave Ste 133, Oakland, CA, 94605-2480
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073099552
Provider Name
Kimberly Lyles Butts
Credential
Provider Entity Type
Individual
Gender
Female
Address
7200 Bancroft Ave Ste 133, Oakland, CA, 94605-2480
Phone Number
510-421-4739
Fax Number
Provider Enumeration Date
07/17/2018
Last Update Date
03/13/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
B9627718 01 CA CALIFORNIA ID
institution
Provider Business Practice Location Address Details
Address
7200 Bancroft Ave Ste 133
City
Oakland
State
California
Zip
94605-2480
Phone Number
510-421-4739
Fax Number
person
Provider Business Mailing Address Details
Address
7200 Bancroft Ave Ste 133
City
Oakland
State
California
Zip
94605-2480
Phone Number
510-421-4739
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
MPSS-MKHLRT (California)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Peer Specialist
Speciality
-
Taxonomy
175T00000X
License No.
()
Definition
Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
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