MEDICARE: KIMBERLY BROUNSTEIN MA, AMFT

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	AMFT147064	CA

General Provider Information

NPI Number	:	1629881875
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY BROUNSTEIN MA, AMFT

Provider Business Mailing Address
First Line	:	1027 PALM AVE APT 4
Second Line	:
City	:	SOUTH PASADENA
State	:	CA
Zip	:	91030-5304
Country	:	US
Telephone Number	:	310-947-1647
Fax Number	:

Provider Business Practice Location Address
First Line	:	11777 SAN VICENTE BLVD STE 700
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90049-5052
Country	:	US
Telephone Number	:	424-234-6382
Fax Number	:

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

Provider Enumeration Date	:	01/30/2025
Last Update Date	:	01/30/2025

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