Provider Demographics
NPI:1558740977
Name:WEST, KIM
Entity Type:Individual
Prefix:
First Name:KIM
Middle Name:
Last Name:WEST
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 WESTMOOR AVE
Mailing Address - Street 2:
Mailing Address - City:DALY CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94015-4547
Mailing Address - Country:US
Mailing Address - Phone:650-599-9955
Mailing Address - Fax:650-599-9273
Practice Address - Street 1:1111 MARKET ST
Practice Address - Street 2:FIRST FLOO
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94103-1513
Practice Address - Country:US
Practice Address - Phone:415-863-3883
Practice Address - Fax:415-863-7343
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-19
Last Update Date:2016-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)