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

Individual provider Clinical Social Worker · NPI 1083784938

Kimberly Hairston, LCSW is a Clinical Social Worker in Ontario, California. Qualified in 1998, 28 years ago. Practices with Sud Specialty Group - Ca, a 499-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
28
Licensed in
CA
In the registry since
2006
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

4872 S Anderson Ave
Ontario, CA 91762-7588
Phone: (213) 706-1359
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 21513 (CA)

Record details

NPI number1083784938
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 8, 2006
Last updated in NPPESJanuary 12, 2026
Certification dateJanuary 12, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 1998 (28 years in practice)
Group practice Sud Specialty Group - Ca — 499 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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