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NPI Code Detail

MEDICARE: MS. KIMBERLE SARAH KONOVER ASW

MEDICARE: MS. KIMBERLE SARAH KONOVER ASW
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
11041C0700XClinical Social Worker
21041C0700XClinical Social Worker28102CA

General Provider Information

NPI Number : 1841313384
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KIMBERLE SARAH KONOVER ASW
Provider Business Mailing Address
First Line : 770 53RD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1814
Country : US
Telephone Number : 510-517-1333
Fax Number :
Provider Business Practice Location Address
First Line : 770 53RD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94609-1814
Country : US
Telephone Number : 510-517-1333
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/09/2007
Last Update Date : 03/28/2024

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