=====================================================
General NPI Number Information
=====================================================
NPI Number | 1477343093
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KIMBERLEY A WASHINGTON PPSC, CWA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/07/2025
-----------------------------------------------------
Last Update Date | 05/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 320 N J ST
-----------------------------------------------------
City | LOMPOC
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93436-5925
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-742-2940
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1301 N A ST
-----------------------------------------------------
City | LOMPOC
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93436-3516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-743-3000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YS0200X
-----------------------------------------------------
Taxonomy Name | School Counselor
-----------------------------------------------------
License Number | 230138353
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------