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Individual
KIMBERLY MARTIN
Active
Individual
KIMBERLY MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
176124V
CA
103TA0400X
Addiction (Substance Use Disorder) Psychologist
PSY34834
CA
103TC0700X
Clinical Psychologist
Primary
PSY34834
CA
Other
Enumeration date
02/06/2024
Last updated
02/06/2024
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