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General NPI Number Information
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NPI Number | 1376155960
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Entity Type | Individual
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Provider Name | KIMBERLY ANNE BARDEN SCHOOL PSYCHOLOGIST
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Gender | Female
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Dates
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Enumeration Date | 08/17/2020
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Last Update Date | 08/17/2020
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Provider Practice Location Address
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Address Line | 2240 OLD RIVER RD
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City | UKIAH
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State | CA
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Zip | 95482-6103
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Country | US
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Telephone | 707-467-5191
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Fax |
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Provider Business Mailing Address
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Address Line | 609 EMPIRE DR
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City | UKIAH
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State | CA
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Zip | 95482-7257
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Country | US
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Telephone | 530-598-9759
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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 | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number | 200103522
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License Number State | CA
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