Provider Demographics
NPI:1033303441
Name:PIER, KIMBALL CONVERSE (PHD, LMFT)
Entity Type:Individual
Prefix:MS
First Name:KIMBALL
Middle Name:CONVERSE
Last Name:PIER
Suffix:
Gender:F
Credentials:PHD, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1794
Mailing Address - Street 2:
Mailing Address - City:BISHOP
Mailing Address - State:CA
Mailing Address - Zip Code:93515-1794
Mailing Address - Country:US
Mailing Address - Phone:530-536-8695
Mailing Address - Fax:
Practice Address - Street 1:64A FOOTHILL RD
Practice Address - Street 2:
Practice Address - City:BISHOP
Practice Address - State:CA
Practice Address - Zip Code:93514-7166
Practice Address - Country:US
Practice Address - Phone:530-536-8695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-29
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 44285106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist