Individual
MS. BENITA KIMBALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
1329 HOWE AVE STE 101, SACRAMENTO, CA 95825-3363
(916) 480-9501
(510) 350-9166
Mailing address
1329 HOWE AVE STE 101, SACRAMENTO, CA 95825-3363
(916) 480-9501
(510) 350-9166
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
C52184
CA
224900000X
Mastectomy Fitter
Primary
C52184
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C52184
BOC
CA
Enumeration date
09/11/2015
Last updated
02/27/2024
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