Provider Demographics
NPI:1346517976
Name:DEL VALLE, KIMBER (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KIMBER
Middle Name:
Last Name:DEL VALLE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 E 28TH ST STE 309
Mailing Address - Street 2:
Mailing Address - City:SIGNAL HILL
Mailing Address - State:CA
Mailing Address - Zip Code:90755-2181
Mailing Address - Country:US
Mailing Address - Phone:562-852-2084
Mailing Address - Fax:
Practice Address - Street 1:2301 E 28TH ST STE 309
Practice Address - Street 2:
Practice Address - City:SIGNAL HILL
Practice Address - State:CA
Practice Address - Zip Code:90755-2181
Practice Address - Country:US
Practice Address - Phone:562-852-2084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-28
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21749103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical