Provider Demographics
NPI:1629691993
Name:WIMBERLY, FRANKLIN CLIFFORD (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:CLIFFORD
Last Name:WIMBERLY
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLEASANT WALK
Mailing Address - Street 2:
Mailing Address - City:ALISO VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92656-4266
Mailing Address - Country:US
Mailing Address - Phone:949-525-2398
Mailing Address - Fax:
Practice Address - Street 1:10 PLEASANT WALK
Practice Address - Street 2:
Practice Address - City:ALISO VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92656-4266
Practice Address - Country:US
Practice Address - Phone:949-525-2398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-21
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114917103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral