Individual
MRS. KIMBERLY MACIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2929 MEADE AVE, SAN DIEGO, CA 92116-4251
(619) 281-8313
Mailing address
2929 MEADE AVE, SAN DIEGO, CA 92116-4251
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
5752
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2017
Last updated
10/09/2018
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