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General NPI Number Information
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NPI Number | 1487270898
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Entity Type | Organization
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Legal Business Name | KIMBERLY ZEVALLOS FAMILY THERAPY, INC.
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Dates
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Enumeration Date | 06/22/2020
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Last Update Date | 02/15/2021
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Provider Practice Location Address
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Address Line | 145 HODENCAMP RD STE 204
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5817
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Country | US
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Telephone | 818-639-2254
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Fax |
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Provider Business Mailing Address
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Address Line | 145 HODENCAMP RD STE 204
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City | THOUSAND OAKS
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State | CA
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Zip | 91360-5817
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Country | US
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Telephone | 805-410-4541
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | KIMBERLY ZEVALLOS
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Credential | LMFT
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Telephone | 805-410-4541
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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 |
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License Number State |
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