Provider Demographics
NPI:1932468592
Name:NGUYEN, KIMBERLY (PSYD, LMFT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:PSYD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 4TH ST
Mailing Address - Street 2:UNIT 414
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94107-1618
Mailing Address - Country:US
Mailing Address - Phone:650-644-7831
Mailing Address - Fax:
Practice Address - Street 1:660 4TH ST UNIT 414
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94107-1618
Practice Address - Country:US
Practice Address - Phone:650-644-7831
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY35195103TC0700X
CA96981106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty