Healthcare Provider Details

I. General information

NPI: 1578979506
Provider Name (Legal Business Name): KIMBERLY E HALL-SNOWDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2014
Last Update Date: 11/02/2024
Certification Date: 11/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

341 E 6TH ST
LONG BEACH CA
90802-1402
US

IV. Provider business mailing address

19401 S VERMONT AVE STE A200
TORRANCE CA
90502-4418
US

V. Phone/Fax

Practice location:
  • Phone: 562-435-7350
  • Fax:
Mailing address:
  • Phone: 310-323-6887
  • Fax: 310-436-8285

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: