Provider Demographics
NPI:1093920571
Name:HARLEY, KIMBERLY CURRY (IMF)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:CURRY
Last Name:HARLEY
Suffix:
Gender:F
Credentials:IMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 HILLSBOROUGH ST
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91361-1330
Mailing Address - Country:US
Mailing Address - Phone:805-497-6292
Mailing Address - Fax:
Practice Address - Street 1:1305 DEL NORTE RD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8436
Practice Address - Country:US
Practice Address - Phone:805-485-6114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 50268106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist