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General NPI Number Information
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NPI Number | 1306526538
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Entity Type | Organization
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Legal Business Name | KIMBERLY M HOLTON
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Dates
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Enumeration Date | 07/21/2023
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 10630 TOWN CENTER DR STE 111
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91730-6888
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Country | US
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Telephone | 909-277-3212
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Fax |
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Provider Business Mailing Address
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Address Line | 1552 REDHILL NORTH DR
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City | UPLAND
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State | CA
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Zip | 91786-2407
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KIMBERLY HOLTON
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Credential |
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Telephone | 951-465-5366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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