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NPI Code Detail

MEDICARE: KIMBERLY DEHESA

MEDICARE: KIMBERLY DEHESA
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
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1487518411
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIMBERLY DEHESA
Provider Business Mailing Address
First Line : 35587 PENROSE LN
Second Line :
City : YUCAIPA
State : CA
Zip : 92399-5570
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11799 SEBASTIAN WAY STE 103
Second Line :
City : RANCHO CUCAMONGA
State : CA
Zip : 91730-0708
Country : US
Telephone Number : 909-942-1630
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2025
Last Update Date : 12/15/2025

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Directions to “ KIMBERLY DEHESA ” Practice Location

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