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General NPI Number Information
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NPI Number | 1972309441
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Entity Type | Individual
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Provider Name | KIMBERLY BERENICE AMAYA
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 100 N BARRANCA ST # 130
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City | WEST COVINA
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State | CA
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Zip | 91791-1637
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Country | US
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Telephone | 626-254-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 9713 LONGDEN AVE
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City | TEMPLE CITY
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State | CA
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Zip | 91780-1452
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Country | US
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Telephone | 323-244-5062
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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