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Individual
DR. KIMBERLY BASS DITTU
Active
Individual
DR. KIMBERLY BASS DITTU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD, LCSW
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSB94026042
CA
1041C0700X
Clinical Social Worker
LCSW63288
CA
225C00000X
Rehabilitation Counselor
PSB94026042
CA
Other
Enumeration date
07/23/2009
Last updated
06/16/2023
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