Healthcare Provider Details

I. General information

NPI: 1497186829
Provider Name (Legal Business Name): KIMBERLY BURNETT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2013
Last Update Date: 07/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2737 WEST CECIL AVENUE
DELANO CA
93215
US

IV. Provider business mailing address

12209 HILL COUNTRY DR
BAKERSFIELD CA
93312-6848
US

V. Phone/Fax

Practice location:
  • Phone: 661-721-2345
  • Fax:
Mailing address:
  • Phone: 661-587-6360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS 25878
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: