Provider Demographics
NPI:1013884550
Name:RICHARDSON, KIMBERLY KAI (BIRTHING DOULA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:KAI
Last Name:RICHARDSON
Suffix:
Gender:F
Credentials:BIRTHING DOULA
Other - Prefix:
Other - First Name:KIKI
Other - Middle Name:KAI
Other - Last Name:NAVARRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BIRTHING DOULA
Mailing Address - Street 1:2416 CAMELLIA ST
Mailing Address - Street 2:
Mailing Address - City:WASCO
Mailing Address - State:CA
Mailing Address - Zip Code:93280-2410
Mailing Address - Country:US
Mailing Address - Phone:661-900-3540
Mailing Address - Fax:661-405-2191
Practice Address - Street 1:2416 CAMELLIA ST
Practice Address - Street 2:
Practice Address - City:WASCO
Practice Address - State:CA
Practice Address - Zip Code:93280-2410
Practice Address - Country:US
Practice Address - Phone:661-900-3540
Practice Address - Fax:661-405-2191
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X, 175L00000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No175L00000XOther Service ProvidersHomeopathGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty