Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberlee Ilise Mattingley, BA, SUDCC

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1912553702

Kimberlee Ilise Mattingley, BA, SUDCC is an Addiction (Substance Use Disorder) Counselor in Shingle Springs, California. Licensed in California. Registered with an NPI since 2019.

Licensed in
CA
In the registry since
2019
What do these letters mean?
BA — Bachelor of Arts
An undergraduate arts degree.

See every abbreviation used in this directory →

Practice location Address checks out

3974 Durock Rd Ste 205
Shingle Springs, CA 95682-8568
Phone: (530) 621-4687
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence 10848 (CA)

Record details

NPI number1912553702
Entity typeIndividual (Type 1)
GenderFemale
Credentials BA , SUDCC
Sole proprietorNo
NPI enumeratedAugust 16, 2019
Last updated in NPPESOctober 28, 2022
Certification dateOctober 28, 2022