Healthcare Provider Details

I. General information

NPI: 1871411629
Provider Name (Legal Business Name): TWO PALMS FAMILY THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 CLEARWATER LN
NIPOMO CA
93444-8964
US

IV. Provider business mailing address

PO BOX 158
WRIGHTWOOD CA
92397-0158
US

V. Phone/Fax

Practice location:
  • Phone: 805-242-2013
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. PATRICIA ELIZABETH HOPE KIMMEL
Title or Position: CEO
Credential: MA, LPCC
Phone: 805-242-2013