Healthcare Provider Details

I. General information

NPI: 1427459460
Provider Name (Legal Business Name): KIMBERLY A MOBERLY M.A.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KIMBERLY A FRIED LMFT

II. Dates (important events)

Enumeration Date: 09/09/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23181 LA CADENA DR STE 101
LAGUNA HILLS CA
92653-1479
US

IV. Provider business mailing address

21282 BISHOP
MISSION VIEJO CA
92692-4063
US

V. Phone/Fax

Practice location:
  • Phone: 760-500-3325
  • Fax: 760-800-4099
Mailing address:
  • Phone: 949-525-3641
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF79194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: