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General NPI Number Information
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NPI Number | 1679001457
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Entity Type | Individual
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Provider Name | KIMBERLEY RENEE MCGINTY LMFT
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Gender | Female
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Dates
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Enumeration Date | 05/24/2017
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Last Update Date | 05/24/2017
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Provider Practice Location Address
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Address Line | 3200 E GUASTI RD STE 100
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City | ONTARIO
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State | CA
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Zip | 91761-8661
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Country | US
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Telephone | 909-684-7164
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Fax |
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Provider Business Mailing Address
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Address Line | 8780 19TH ST # 406
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City | ALTA LOMA
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State | CA
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Zip | 91701-4608
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Country | US
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Telephone | 909-684-7164
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 42152
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License Number State | CA
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