Provider Demographics
NPI:1922864602
Name:BARBER, KIMBERLY ELIZABETH
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ELIZABETH
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-4322
Mailing Address - Country:US
Mailing Address - Phone:424-208-4524
Mailing Address - Fax:
Practice Address - Street 1:2200 PACIFIC COAST HWY STE 210
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2701
Practice Address - Country:US
Practice Address - Phone:310-740-9493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA76082355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant