Provider Demographics
NPI:1225227416
Name:FLOWERS, KIMBERLIE JUNE (MFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLIE
Middle Name:JUNE
Last Name:FLOWERS
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:PO BOX 8925
Mailing Address - Street 2:
Mailing Address - City:TRUCKEE
Mailing Address - State:CA
Mailing Address - Zip Code:96162-8925
Mailing Address - Country:US
Mailing Address - Phone:530-587-6941
Mailing Address - Fax:530-587-6941
Practice Address - Street 1:10356 DONNER PASS RD
Practice Address - Street 2:
Practice Address - City:TRUCKEE
Practice Address - State:CA
Practice Address - Zip Code:96161-0426
Practice Address - Country:US
Practice Address - Phone:916-444-7790
Practice Address - Fax:530-587-6924
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC39041106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist