Provider Demographics
NPI:1326520610
Name:FRERKING RAMOS, KIMBERLEY (RBT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEY
Middle Name:
Last Name:FRERKING RAMOS
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 BALFOUR RD # D-137
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-5515
Mailing Address - Country:US
Mailing Address - Phone:925-354-9685
Mailing Address - Fax:
Practice Address - Street 1:236 GEORGIA ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5991
Practice Address - Country:US
Practice Address - Phone:707-552-2851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician