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General NPI Number Information
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NPI Number | 1043346208
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Entity Type | Individual
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Provider Name | KIMEL A. LIMON PSYD
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Gender | Female
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 04/15/2017
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Provider Practice Location Address
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Address Line | 550 H ST STE 1N
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City | CRESCENT CITY
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State | CA
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Zip | 95531-3736
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Country | US
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Telephone | 541-254-0941
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Fax | 707-812-6106
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Provider Business Mailing Address
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Address Line | 16340 LOWER HARBOR RD # 331
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City | BROOKINGS
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State | OR
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Zip | 97415-8303
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Country | US
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Telephone | 541-254-0941
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Fax | 707-812-6106
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY 17613
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License Number State | CA
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