Provider Demographics
NPI:1477626448
Name:HAWKINS, KIMBALL DON (PHD)
Entity Type:Individual
Prefix:DR
First Name:KIMBALL
Middle Name:DON
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5500 MING AVE
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-4689
Mailing Address - Country:US
Mailing Address - Phone:661-833-6400
Mailing Address - Fax:661-832-2772
Practice Address - Street 1:5500 MING AVE
Practice Address - Street 2:SUITE 130
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-4689
Practice Address - Country:US
Practice Address - Phone:661-833-6400
Practice Address - Fax:661-832-2772
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSYLL749103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist