Provider Demographics
NPI:1427229285
Name:KRAEMER MCHENRY, KIMBERLY LYNN (MA; IMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:LYNN
Last Name:KRAEMER MCHENRY
Suffix:
Gender:F
Credentials:MA; IMFT
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:LYNN
Other - Last Name:KRAEMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA;IMFT
Mailing Address - Street 1:16940 HIGHWAY 14
Mailing Address - Street 2:SUITE F
Mailing Address - City:MOJAVE
Mailing Address - State:CA
Mailing Address - Zip Code:93501-1238
Mailing Address - Country:US
Mailing Address - Phone:661-824-5020
Mailing Address - Fax:661-824-5026
Practice Address - Street 1:16940 HIGHWAY 14
Practice Address - Street 2:SUITE F
Practice Address - City:MOJAVE
Practice Address - State:CA
Practice Address - Zip Code:93501-1238
Practice Address - Country:US
Practice Address - Phone:661-824-5020
Practice Address - Fax:661-824-5026
Is Sole Proprietor?:No
Enumeration Date:2008-03-19
Last Update Date:2009-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF 55808106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist