Provider Demographics
NPI:1609367259
Name:AROCHO, KIMBERLY ILIANA
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ILIANA
Last Name:AROCHO
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 1:1432 REGENT CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:CA
Mailing Address - Zip Code:95648-3222
Mailing Address - Country:US
Mailing Address - Phone:916-295-8329
Mailing Address - Fax:
Practice Address - Street 1:1432 REGENT CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:CA
Practice Address - Zip Code:95648-3222
Practice Address - Country:US
Practice Address - Phone:916-295-8329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst