Healthcare Provider Details

I. General information

NPI: 1497370860
Provider Name (Legal Business Name): KIMBERLY DENISSE TURCIOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2020
Last Update Date: 02/20/2026
Certification Date: 02/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 S OLIVE ST
LOS ANGELES CA
90015-3023
US

IV. Provider business mailing address

1530 S OLIVE ST
LOS ANGELES CA
90015-3023
US

V. Phone/Fax

Practice location:
  • Phone: 213-747-5542
  • Fax:
Mailing address:
  • Phone: 213-747-5542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW131066
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: