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NPI Code Detail

MEDICARE: MRS. KIMARA LANI HOUSEMAN

MEDICARE: MRS. KIMARA LANI HOUSEMAN
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
1106H00000XMarriage & Family Therapist77548CA

General Provider Information

NPI Number : 1558788083
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KIMARA LANI HOUSEMAN
Provider Business Mailing Address
First Line : 3002 ARMSTRONG ST
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-5702
Country : US
Telephone Number : 858-277-9550
Fax Number :
Provider Business Practice Location Address
First Line : 11526 SORRENTO VALLEY RD STE F
Second Line :
City : SAN DIEGO
State : CA
Zip : 92121-1314
Country : US
Telephone Number : 858-224-2838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2014
Last Update Date : 12/09/2021

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Directions to “ MRS. KIMARA LANI HOUSEMAN ” Practice Location

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