Healthcare Provider Details

I. General information

NPI: 1114252749
Provider Name (Legal Business Name): KIMBERLY ERIN D'AMICO MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/15/2009
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 SILVER SPUR RD
ROLLING HILLS ESTATES CA
90275-3601
US

IV. Provider business mailing address

550 SILVER SPUR RD
ROLLING HILLS ESTATES CA
90275-3601
US

V. Phone/Fax

Practice location:
  • Phone: 310-874-1145
  • Fax:
Mailing address:
  • Phone: 310-874-1145
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number28244
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: