EXCLUDEDPROVIDER
Individual Revocation

Kimberly Kae Staples

Forestville, CA 95436

Public HHS-OIG LEIE exclusion record

According to the HHS-OIG List of Excluded Individuals/Entities (LEIE), Kimberly Kae Staples of Forestville, CA is currently excluded from participation in federally funded health care programs due to license revocation, suspension, or surrender, as of October 20, 2005.

Status
Currently listed by HHS-OIG
Record type
Individual
Location
Forestville, CA 95436
Exclusion date
October 20, 2005
Exclusion type
Revocation (1128b4)
Source dataset
May 2026

Record summary

Kimberly Kae Staples appears in the HHS-OIG List of Excluded Individuals/Entities (LEIE) public dataset as an individual record associated with Forestville, California. The latest imported LEIE dataset lists this record as currently excluded from participation in federally funded health care programs. The exclusion date shown in the source record is October 20, 2005, and the exclusion type is 1128b4, identified by HHS-OIG as license revocation, suspension, or surrender.

Source record

SourceHHS-OIG LEIE (public dataset)
Record typeIndividual
Current statusCurrently listed by HHS-OIG
Exclusion dateOctober 20, 2005
Exclusion typeLicense revocation, suspension, or surrender (1128b4)
Source dataset dateMay 2026

What this exclusion type means

HHS-OIG identifies exclusion type 1128b4 as “License revocation, suspension, or surrender.” License revocation, suspension, or surrender (permissive exclusion).

This exclusion type is a statutory category used by HHS-OIG in the LEIE dataset. The category describes the legal authority associated with the exclusion record, not a separate investigation or additional reporting by Excluded Provider.

Location and provider classification

This LEIE record is associated with Forestville, CA 95436. The listed provider category is Nursing Profession. The listed specialty is Nurse / Nurses Aide.

Other excluded providers in Forestville, CA

Other individuals and entities currently listed in the HHS-OIG LEIE public dataset with a Forestville, CA address.

Laura Ann Roche Individual Revocation
Forestville, CA · License revocation, suspension, or surrender · Excluded May 2016
Kathleen L Martin Individual Loan Default
Forestville, CA · Default on health education loan or scholarship obligations · Excluded Oct 2003

How to verify this record

This page is a public-record summary and should be treated as a possible LEIE match, not final identity verification. To verify the record, use the official HHS-OIG LEIE search and compare available identifying information through the official process. Name, location, provider category, specialty, exclusion date, and NPI should be treated as matching clues rather than final proof of identity.

What this page does not include

This page summarizes the HHS-OIG LEIE public dataset only. It does not search state Medicaid exclusion lists, state licensing-board actions, court records, malpractice records, employment history, civil lawsuits, or non-public investigations.

Verify with HHS-OIG Remove / correct this record

Related

More Excluded Individuals in California More Records in Forestville More Revocation Records