NPI Code Details Logo

NPI 1295569390

NPI 1295569390 : WANNIDA KIM-AMERMAN : SAN JOSE, CA

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1295569390
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    WANNIDA KIM-AMERMAN
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    08/29/2024
-----------------------------------------------------
    Last Update Date     |    07/25/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    101 JOSE FIGUERES AVE STE 50 
-----------------------------------------------------
    City                 |    SAN JOSE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95116-2068
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    408-960-3152
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    1922 THE ALAMEDA STE 316 
-----------------------------------------------------
    City                 |    SAN JOSE
-----------------------------------------------------
    State                |    CA
-----------------------------------------------------
    Zip                  |    95126-1461
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    408-261-7777
-----------------------------------------------------
    Fax                  |    408-642-6052
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    106H00000X
-----------------------------------------------------
    Taxonomy Name        |    Marriage & Family Therapist
-----------------------------------------------------
    License Number       |    AMFT156609
-----------------------------------------------------
    License Number State |    CA
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.