Healthcare Provider Details

I. General information

NPI: 1871407692
Provider Name (Legal Business Name): KIMBERLY JEAN LOUGHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4725 VALLEY VIEW AVE
YORBA LINDA CA
92886-3251
US

IV. Provider business mailing address

19411 SURF DR
HUNTINGTON BEACH CA
92648-5596
US

V. Phone/Fax

Practice location:
  • Phone: 714-266-1541
  • Fax:
Mailing address:
  • Phone: 714-277-9242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP25551
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: