Healthcare Provider Details

I. General information

NPI: 1306781117
Provider Name (Legal Business Name): KIMBERLY ADAMS LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31726 RANCHO VIEJO RD STE 100
SAN JUAN CAPISTRANO CA
92675-2723
US

IV. Provider business mailing address

31726 RANCHO VIEJO RD STE 100
SAN JUAN CAPISTRANO CA
92675-2723
US

V. Phone/Fax

Practice location:
  • Phone: 949-670-8855
  • Fax:
Mailing address:
  • Phone: 949-670-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number18194
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: