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General NPI Number Information
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NPI Number | 1952788192
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Entity Type | Individual
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Provider Name | KIMBERLEE HURWITZ-PROVDA
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Gender | Female
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Dates
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Enumeration Date | 04/27/2015
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 3233 MISSION OAKS BLVD BUILDING C
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City | CAMARILLO
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State | CA
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Zip | 93012
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Country | US
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Telephone | 310-592-8576
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Fax |
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Provider Business Mailing Address
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Address Line | 22836 MARGARITA DR
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City | WOODLAND HILLS
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State | CA
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Zip | 91364-3843
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Country | US
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Telephone | 310-592-8576
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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 |
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License Number State |
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