Healthcare Provider Details

I. General information

NPI: 1740106822
Provider Name (Legal Business Name): KIMBERLY THERESE NG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 S 3RD AVE
ARCADIA CA
91006-3703
US

IV. Provider business mailing address

3536 ROSELAWN AVE
GLENDALE CA
91208-1256
US

V. Phone/Fax

Practice location:
  • Phone: 626-821-8357
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17205
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: