Provider Demographics
NPI:1013043538
Name:WEINANDY, KYMBERLY MICHELLE (MFT)
Entity Type:Individual
Prefix:MS
First Name:KYMBERLY
Middle Name:MICHELLE
Last Name:WEINANDY
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6007 FOLSOM BLVD
Mailing Address - Street 2:#200
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-4613
Mailing Address - Country:US
Mailing Address - Phone:916-799-4615
Mailing Address - Fax:916-737-6507
Practice Address - Street 1:6007 FOLSOM BLVD
Practice Address - Street 2:#200
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-4613
Practice Address - Country:US
Practice Address - Phone:916-799-4615
Practice Address - Fax:916-737-6507
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC42125106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist