MEDICARE: MISS KIMBERLY NARAINE LCSW

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		CA
2	1041C0700X	Clinical Social Worker	100413	CA

General Provider Information

NPI Number	:	1568868016
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS KIMBERLY NARAINE LCSW

Provider Business Mailing Address
First Line	:	18 RANA
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-1531
Country	:	US
Telephone Number	:	951-973-3535
Fax Number	:

Provider Business Practice Location Address
First Line	:	505 N TUSTIN AVE STE 182
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92705-3775
Country	:	US
Telephone Number	:	714-274-7577
Fax Number	:

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

Provider Enumeration Date	:	11/11/2014
Last Update Date	:	08/29/2022

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