KIMBERLY SHADEAN WEDDERBURN
Counselor

Address: 2200 Hayes St Fl 3, San Francisco, CA 94117-1013

KIMBERLY SHADEAN WEDDERBURN (NPI# 1417501347) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417501347
Entity Type Individual
Full Name KIMBERLY SHADEAN WEDDERBURN
Gender Female
Credential CTRS
Practice Address 2200 Hayes St Fl 3
San Francisco
CA 94117-1013
Practice Telephone 4157505649
Mailing Address 4418 Continental Way
Stockton
CA 95207-8930
Mailing Telephone 3058348948
Enumeration Date 2019-07-29
Last Update Date 2019-08-07
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification Taxonomy Group License Number License State Grouping
Y 101Y00000X Counselor Behavioral Health & Social Service Providers
N 225800000X Recreation Therapist 67715 FL Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifiers

Identifier State Issuer Type Code
0000000000 NA Other

Associated Endpoints

Endpoint Type Endpoint Affiliation Affiliation Address Use Content
Other URL NA (NA) 2200 Hayes St Fl 3, San Francisco, CA 941171013 Direct Other NA

Office Location

Street Address 2200 HAYES ST FL 3
City SAN FRANCISCO
State CA
Zip Code 94117-1013

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1093719817 Bay Area Rehabilitation Medical Group Physical Medicine & Rehabilitation 2250 Hayes St, San Francisco, CA 94117-1013 2005-06-09
1124021621 Robert D. Sine Physical Medicine & Rehabilitation 2250 Hayes St, San Francisco, CA 94117-1013 2005-05-27
1396748935 Bay Area Rehabilitation Medical Group Physical Medicine & Rehabilitation 2250 Hayes St, San Francisco, CA 94117-1013 2005-05-27
1285675355 David Peihang Shu Internal Medicine 2250 Hayes St, Suite 203, San Francisco, CA 94117-1013 2006-06-09
1396748893 Kenneth B. Fechtner Physical Medicine & Rehabilitation 2250 Hayes St, San Francisco, CA 94117-1013 2005-05-27
1578142238 Lauren Nicole Chester Counselor 2200 Hayes St Fl 6, San Francisco, CA 94117-1013 2021-04-07
1063413714 Kwok L Chan Internal Medicine 2250 Hayes St, Suite 502, San Francisco, CA 94117-1013 2005-08-03
1346225430 Derice Patricia Seid Internal Medicine 2250 Hayes St, Ste 500, San Francisco, CA 94117-1013 2005-12-12

Providers in the same zip code prefix

NPI Name Taxonomy Address Enumeration
1174842041 Eric Michael Fine Clinical Neuropsychologist 533 Parnassus Ave, Uc Hall 426, Ucsf Memory and Aging Center, San Francisco, CA 94117 2010-05-18
1326356460 Paul Anthony Fitzgerald Internal Medicine 350 Parnassus Avenue, Suite 710, San Francisco, CA 94117 2010-09-23
1124578901 Michelle Elizabeth Cohen Nurse Practitioner - Family 350 Parnassus Ave Ste 908, San Francisco, CA 94117 2016-10-05
1265765622 William Jagust Psychiatry & Neurology - Neurology 350 Parnassus, Suite 905, University of California, Memory and Aging Center, San Francisco, CA 94117 2009-09-16
1679981096 Alex Garo Tanielian Dentist - General Practice 786 Haight St, San Francisco, CA 94117 2014-07-29
1497066500 John J O'Dowd Marriage & Family Therapist 890 Hayes St., Walden House, San Francisco, CA 94117 2010-06-24
1033497508 Karen Lynn De Castro Jacques · Karen Lynn B. De Castro Occupational Therapist 1245 Oak Street, #1, San Francisco, CA 94117 2011-08-01
1629358957 Latille Lashonda Phillips Counselor 1140 Oak Street, San Francisco, CA 94117 2011-08-18
1851790430 Elissa Stevens Counselor 1757 Waller Street, San Francisco, CA 94117 2014-08-19
1699043810 Podiatry Plan Inc · Health Plans Organization of California Podiatrist - Foot & Ankle Surgery 1353b Haight Street, San Francisco, CA 94117 2011-12-02
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Taxonomy Information

Taxonomy Code 101Y00000X
Grouping Behavioral Health & Social Service Providers
Classification Counselor

Taxonomy Definition

A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master’s degree and clinical experience and supervision for licensure or certification.
Notes: Sources: Abridged from definitions provided by the National Board of Certified Counselors and the American Association of Pastoral Counselors.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1952978397 Yvette Garcia Hernandez Counselor 700 Felton St, San Francisco, CA 94134-1465 2021-06-04
1710561576 Vanessa Stefanelli Counselor 1975 4th St Dept Of, San Francisco, CA 94143-2351 2021-05-07
1255912671 Geoffrey M Fletcher Counselor 111 Chestnut St Unit 705, San Francisco, CA 94111-1035 2021-04-16
1578142238 Lauren Nicole Chester Counselor 2200 Hayes St Fl 6, San Francisco, CA 94117-1013 2021-04-07
1215533799 Dominique Rosa Leslie Counselor 835 Hyde St, San Francisco, CA 94109-5927 2020-12-09
1972104628 Ann Egan Counselor 207 Cole St, San Francisco, CA 94117-1915 2020-11-07
1326654518 Mina Dailami Counselor 45 Adair St Apt A, San Francisco, CA 94103-3699 2020-09-22
1538773841 Samantha Santamaria Counselor 1001 Potrero Ave Rm 7g12, San Francisco, CA 94110-3518 2020-09-03
1659980076 Claire Katherine Sheeran Counselor 1275 34th Ave, San Francisco, CA 94122-1306 2020-07-31
1104434331 Archana Chatkara Thomas · Archana Chatkara Counselor 974 Pine St Apt 9, San Francisco, CA 94108-2928 2020-07-14
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Competitor

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City SAN FRANCISCO
Zip Code 94117

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.