Healthcare Provider Details

I. General information

NPI: 1184710972
Provider Name (Legal Business Name): KIMBERLY KAY KLEINSCHMIDT R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 S VERMONT AVE 6TH FLOOR
LOS ANGELES CA
90020-1912
US

IV. Provider business mailing address

245 HEATHER HEIGHTS CT
MONROVIA CA
91016-2041
US

V. Phone/Fax

Practice location:
  • Phone: 213-351-6856
  • Fax:
Mailing address:
  • Phone: 213-351-6856
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberRN275379
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: