Provider Demographics
NPI:1437615663
Name:BRAUNINGER, KIMBERLY HOPE (MA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:HOPE
Last Name:BRAUNINGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7733 COWAN AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-1134
Mailing Address - Country:US
Mailing Address - Phone:310-486-4205
Mailing Address - Fax:
Practice Address - Street 1:14717 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:LAWNDALE
Practice Address - State:CA
Practice Address - Zip Code:90260-1549
Practice Address - Country:US
Practice Address - Phone:310-310-3550
Practice Address - Fax:213-402-2101
Is Sole Proprietor?:No
Enumeration Date:2019-02-12
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109175106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist