Provider Demographics
NPI:1891496956
Name:FRIESEN, KYMBERLY IRENE (MA, PSS)
Entity Type:Individual
Prefix:MRS
First Name:KYMBERLY
Middle Name:IRENE
Last Name:FRIESEN
Suffix:
Gender:F
Credentials:MA, PSS
Other - Prefix:
Other - First Name:KYM
Other - Middle Name:IRENE
Other - Last Name:OLIVAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:1519 GREENWICH CIR
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-7003
Mailing Address - Country:US
Mailing Address - Phone:530-933-6294
Mailing Address - Fax:530-645-7532
Practice Address - Street 1:1519 GREENWICH CIR
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-7003
Practice Address - Country:US
Practice Address - Phone:530-933-6294
Practice Address - Fax:530-645-7532
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-15
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist