Provider Demographics
NPI:1336022789
Name:NOBLE, KIMBERLY (OTR/L)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:NOBLE
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:
Other - Last Name:SAYAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:3674 SAN ANSELINE AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2701
Mailing Address - Country:US
Mailing Address - Phone:562-645-6811
Mailing Address - Fax:
Practice Address - Street 1:3674 SAN ANSELINE AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-2701
Practice Address - Country:US
Practice Address - Phone:562-645-6811
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10869225XG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XG0600XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGerontology