Provider Demographics
NPI:1689002743
Name:TRUONG, KIMBERLY (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:
Last Name:TRUONG
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1423 BELMONT PARK RD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92057-5727
Mailing Address - Country:US
Mailing Address - Phone:888-932-7292
Mailing Address - Fax:
Practice Address - Street 1:23173 LA CADENA DR
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1404
Practice Address - Country:US
Practice Address - Phone:888-932-7292
Practice Address - Fax:714-680-8233
Is Sole Proprietor?:No
Enumeration Date:2013-10-28
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120022106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist