Healthcare Provider Details

I. General information

NPI: 1831723980
Provider Name (Legal Business Name): KIMBERLY N/A FRANCO CTI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2020
Last Update Date: 02/27/2020
Certification Date: 02/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3125 MYERS ST
RIVERSIDE CA
92503-5527
US

IV. Provider business mailing address

6686 SAND DUNES ST
EASTVALE CA
92880-3745
US

V. Phone/Fax

Practice location:
  • Phone: 951-358-4840
  • Fax: 951-358-4848
Mailing address:
  • Phone: 951-847-8569
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: