Healthcare Provider Details

I. General information

NPI: 1306756333
Provider Name (Legal Business Name): KIMBERLY POLINDER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

853 LINDEN AVE
LONG BEACH CA
90813-4516
US

IV. Provider business mailing address

853 LINDEN AVE
LONG BEACH CA
90813-4516
US

V. Phone/Fax

Practice location:
  • Phone: 562-514-4282
  • Fax:
Mailing address:
  • Phone: 562-514-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAPCC18422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: