Provider Demographics
NPI:1891562286
Name:SANCHEZ, KIMBERLIN (LMFT #11192)
Entity Type:Individual
Prefix:
First Name:KIMBERLIN
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LMFT #11192
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8003 WINTER GARDENS BLVD APT 314
Mailing Address - Street 2:
Mailing Address - City:EL CAJON
Mailing Address - State:CA
Mailing Address - Zip Code:92021-1492
Mailing Address - Country:US
Mailing Address - Phone:623-694-9718
Mailing Address - Fax:
Practice Address - Street 1:5639 LA JOLLA BLVD
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-7524
Practice Address - Country:US
Practice Address - Phone:623-694-9718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111982106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist