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General NPI Number Information
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NPI Number | 1518366327
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Entity Type | Individual
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Provider Name | KIMBERLY A HOLLAND LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/18/2014
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Last Update Date | 01/11/2018
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Provider Practice Location Address
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Address Line | 631 TENNESSEE STREET SUITE 201
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City | VALLEJO
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State | CA
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Zip | 94590
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Country | US
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Telephone | 707-652-3852
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Fax | 707-422-0465
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Provider Business Mailing Address
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Address Line | PO BOX 403
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City | BENICIA
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State | CA
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Zip | 94510
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Country | US
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Telephone | 707-652-3852
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Fax | 707-422-0465
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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 | 76772
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 92783
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License Number State | CA
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