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NPI Code Detail

MEDICARE: MS. KIMBERLY MICHELLE WARFIELD SUD COUNSELOR

MEDICARE: MS. KIMBERLY MICHELLE WARFIELD SUD COUNSELOR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1043368376
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLY MICHELLE WARFIELD SUD COUNSELOR
Provider Business Mailing Address
First Line : 5715 S BROADWAY
Second Line :
City : LOS ANGELES
State : CA
Zip : 90037-4131
Country : US
Telephone Number : 323-948-0444
Fax Number : 323-948-0424
Provider Business Practice Location Address
First Line : 2307 W 6TH ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90057-3119
Country : US
Telephone Number : 323-674-6803
Fax Number : 213-351-2853
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/05/2007
Last Update Date : 09/11/2024

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