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General NPI Number Information
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NPI Number | 1366260895
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Entity Type | Individual
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Provider Name | KIMBERLEE DEANA BEATH AMFT
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Gender | Female
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Dates
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Enumeration Date | 10/02/2024
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Last Update Date | 10/02/2024
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Provider Practice Location Address
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Address Line | 265 NEVADA ST
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City | AUBURN
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State | CA
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Zip | 95603-4617
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Country | US
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Telephone | 916-647-7488
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Fax |
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Provider Business Mailing Address
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Address Line | 5240 ROCKLIN RD APT 416
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City | ROCKLIN
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State | CA
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Zip | 95677-3528
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Country | US
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Telephone | 916-647-7748
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 144505
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License Number State | CA
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