Provider Information for 1255510830
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Miss KIMBERLYN SANDOVAL LCSW
Sex: Female
NPI: 1255510830
Last Updated: 2023-08-01
Certification Date: 2023-08-01
Certification Date: 2023-08-01
Details
| Name | Value | ||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1255510830 | ||||||||||||||
| Enumeration Date | 2007-10-30 | ||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||
| Sole Proprietor | NO | ||||||||||||||
| Status | Active | ||||||||||||||
| Mailing Address | 2821 H ST BAKERSFIELD, CA 93301-1913 United States Phone: 661-546-6365 | Fax:661-404-5438 | ||||||||||||||
| Primary Practice Address | 1021 4TH ST STE B TAFT, CA 93268-2433 United States Phone: 661-369-5548 | Fax:661-745-0024 | ||||||||||||||
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