Provider Demographics
NPI:1154676328
Name:STRICKER, KIMBERLY RUTH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:RUTH
Last Name:STRICKER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3749 HERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-3712
Mailing Address - Country:US
Mailing Address - Phone:619-937-1629
Mailing Address - Fax:
Practice Address - Street 1:3749 HERMAN AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92104-3712
Practice Address - Country:US
Practice Address - Phone:619-937-1629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 276041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical