MEDICARE: MARNETTA KIMBELL

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	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1972789295
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARNETTA KIMBELL

Provider Business Mailing Address
First Line	:	1460 N LAKE AVE
Second Line	:	SUITE 107
City	:	PASADENA
State	:	CA
Zip	:	91104-2300
Country	:	US
Telephone Number	:	626-398-3796
Fax Number	:	626-398-3895

Provider Business Practice Location Address
First Line	:	1460 N LAKE AVE
Second Line	:	SUITE 107
City	:	PASADENA
State	:	CA
Zip	:	91104-2300
Country	:	US
Telephone Number	:	626-398-3796
Fax Number	:	626-398-3895

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

Provider Enumeration Date	:	01/16/2008
Last Update Date	:	01/16/2008

Similar Medicare Providers

1811948540 — DR. ARTHUR MANOUKIAN M.D.
Practice Location Address:

1460 N LAKE AVE , # 105
PASADENA, CA
91104-2300

Practice Phone: 800-792-2345
Practice Fax:

1114963642 — URDC HUMAN SERVICES CORPORATION
Practice Location Address:

1460 N LAKE AVE
PASADENA, CA
91104-2300

Practice Phone: 626-398-3796
Practice Fax: 626-398-3895

1750424321 — PACIFIC CLINICS
Practice Location Address:

1460 N LAKE AVE
PASADENA, CA
91104-2300

Practice Phone: 626-296-7710
Practice Fax: 626-296-7714

1770766594 — VANESSA ANNWANETT KANISTANAUX
Practice Location Address:

1460 N LAKE AVE , SUITE 107
PASADENA, CA
91104-2300

Practice Phone: 626-398-3796
Practice Fax: 626-398-3895

1437337276 — PACIFIC CLINICS
Practice Location Address:

1460 N LAKE AVE
PASADENA, CA
91104-2300

Practice Phone: 626-463-1021
Practice Fax:

1891963393 — URDC HUMAN SERVICES CORPORATION
Practice Location Address:

1460 N LAKE AVE , SUITE 107
PASADENA, CA
91104-2300

Practice Phone: 626-398-3796
Practice Fax: 626-398-3895

Directions to “ MARNETTA KIMBELL ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.