MEDICARE: KIM KABAR

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
1	101YM0800X	Mental Health Counselor	115632	CA
2	171M00000X	Case Manager/Care Coordinator
3	390200000X	Student in an Organized Health Care Education/Training Program		CA
4	106H00000X	Marriage & Family Therapist	115632	CA

General Provider Information

NPI Number	:	1053738492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIM KABAR

Provider Business Mailing Address
First Line	:	22 62ND PL APT 6
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5695
Country	:	US
Telephone Number	:	562-725-8539
Fax Number	:

Provider Business Practice Location Address
First Line	:	22 62ND PL APT 6
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90803-5695
Country	:	US
Telephone Number	:	562-725-8539
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/24/2014
Last Update Date	:	08/29/2025

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Directions to “ KIM KABAR ” Practice Location

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