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General NPI Number Information
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NPI Number | 1487058483
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Entity Type | Individual
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Provider Name | KIMBERLY DAWN ROSS LMFT
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Gender | Female
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Dates
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Enumeration Date | 10/20/2014
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 1646 FERRY ST
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City | ANDERSON
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State | CA
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Zip | 96007-3314
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Country | US
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Telephone | 305-378-7060
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Fax |
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Provider Business Mailing Address
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Address Line | 1645 MILL ST
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City | ANDERSON
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State | CA
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Zip | 96007-3226
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Country | US
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Telephone | 530-378-7000
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Fax | 530-378-7001
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT103276
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License Number State | CA
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