Healthcare Provider Details

I. General information

NPI: 1316867617
Provider Name (Legal Business Name): KIMBERLY LYNN HOLZEM AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 W CENTER AVE
VISALIA CA
93291-5911
US

IV. Provider business mailing address

PO BOX 503
THREE RIVERS CA
93271-0503
US

V. Phone/Fax

Practice location:
  • Phone: 559-280-5756
  • Fax:
Mailing address:
  • Phone: 559-936-6437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number164552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: