Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XM0800X | Mental Health | 10168 | CA |
NPI | 1063701621 |
---|---|
Provider Name | Kimberly Rice |
First Address | Los Angeles, CA 90027 |
Second Address | Los Angeles, CA 90027 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2011 |
Last Update Date | 09/07/2013 |