Individual
KIMBERLY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LEP
Contact information
Practice address
26 DEERBORN DR, ALISO VIEJO, CA 92656-5285
(949) 872-4009
Mailing address
26 DEERBORN DR, ALISO VIEJO, CA 92656-5285
(949) 872-4009
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
4173
CA
103TS0200X
School Psychologist
4173
CA
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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