Provider Demographics
NPI:1013341189
Name:SCHWAB, KIMBERLY L (MA, LPCC #6931)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:L
Last Name:SCHWAB
Suffix:
Gender:F
Credentials:MA, LPCC #6931
Other - Prefix:MISS
Other - First Name:KIMBERLY
Other - Middle Name:L
Other - Last Name:GOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CAC I
Mailing Address - Street 1:5575 HOSPITAL DR.
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-2532
Mailing Address - Country:US
Mailing Address - Phone:805-461-6071
Mailing Address - Fax:
Practice Address - Street 1:5575 HOSPITAL DR.
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422
Practice Address - Country:US
Practice Address - Phone:805-461-6071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6931101YM0800X
CAPCCI 2696101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health