Individual
KIMBERLEE FAVELA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18501 GALE AVE STE 100, CITY OF INDUSTRY, CA 91748-1359
(626) 626-4997
Mailing address
18501 GALE AVE STE 100, CITY OF INDUSTRY, CA 91748-1359
(626) 626-4997
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
40669
CA
Other
Enumeration date
10/25/2022
Last updated
10/25/2022
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