Individual
DR. ELLI KIMBAUER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1080 MASON MALL, 6A, CRESCENT CITY, CA 95531-4334
(707) 464-7662
(707) 464-7864
Mailing address
1080 MASON MALL, 6A, CRESCENT CITY, CA 95531-4334
(707) 464-7662
(707) 464-7864
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY 18816
CA
Other
Enumeration date
08/05/2006
Last updated
07/09/2007
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