Healthcare Provider Details

I. General information

NPI: 1396368411
Provider Name (Legal Business Name): KIMBERLY G GALINDO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2020
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 W CENTURY BLVD FL 6
LOS ANGELES CA
90045-6401
US

IV. Provider business mailing address

27305 LIVE OAK RD STE A
CASTAIC CA
91384-4520
US

V. Phone/Fax

Practice location:
  • Phone: 310-908-0979
  • Fax:
Mailing address:
  • Phone: 310-908-0979
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95039251
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95221027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: