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General NPI Number Information
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NPI Number | 1952735623
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Entity Type | Individual
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Provider Name | KIMBERLY FARLEY
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Gender | Female
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Dates
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Enumeration Date | 08/29/2013
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Last Update Date | 03/08/2018
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Provider Practice Location Address
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Address Line | 1317 W FOOTHILL BLVD STE 140
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City | UPLAND
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State | CA
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Zip | 91786-3686
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Country | US
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Telephone | 626-701-4249
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 E FOOTHILL BLVD
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City | PASADENA
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State | CA
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Zip | 91107-3464
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Country | US
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Telephone | 626-564-1613
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 82793
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License Number State | CA
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