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General NPI Number Information
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NPI Number | 1932239522
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Entity Type | Individual
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Provider Name | KIMBERLY ESTELLE CLAYBORN LICENSED MARRIAGE &
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Gender | Female
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Dates
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Enumeration Date | 03/06/2007
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 420 S. BEVERLY DRIVE #100
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City | BEVERLY HILLS
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State | CA
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Zip | 90212
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Country | US
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Telephone | 323-419-8274
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 45196
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City | LOS ANGELES
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State | CA
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Zip | 90045
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Country | US
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Telephone | 323-419-8274
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 44162
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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 | MFC44162
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License Number State | CA
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