Provider Demographics
NPI:1740742238
Name:SALYER, KIMBERLY (LMFT)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:SALYER
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 1:1540 TAHOE CIR
Mailing Address - Street 2:
Mailing Address - City:TRACY
Mailing Address - State:CA
Mailing Address - Zip Code:95376-8904
Mailing Address - Country:US
Mailing Address - Phone:909-702-7934
Mailing Address - Fax:
Practice Address - Street 1:1540 TAHOE CIR
Practice Address - Street 2:
Practice Address - City:TRACY
Practice Address - State:CA
Practice Address - Zip Code:95376-8904
Practice Address - Country:US
Practice Address - Phone:909-702-7934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2022-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96346101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty