Healthcare Provider Details

I. General information

NPI: 1063398410
Provider Name (Legal Business Name): KIMBERLY LEUNG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 VALENCIA ST
SAN FRANCISCO CA
94103-3547
US

IV. Provider business mailing address

132 AVALON DR
DALY CITY CA
94015-4553
US

V. Phone/Fax

Practice location:
  • Phone: 415-714-2460
  • Fax:
Mailing address:
  • Phone: 650-863-0534
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number95304290
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: