Provider Demographics
NPI:1023410685
Name:PINKERT, KIMBERLY ANN (MS, BCBA)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:ANN
Last Name:PINKERT
Suffix:
Gender:F
Credentials:MS, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1907 CENTRAL AVE
Mailing Address - Street 2:APT K
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-2673
Mailing Address - Country:US
Mailing Address - Phone:417-988-0290
Mailing Address - Fax:
Practice Address - Street 1:3732 MT DIABLO BLVD
Practice Address - Street 2:SUITE 395
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3632
Practice Address - Country:US
Practice Address - Phone:925-239-5623
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-25
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11416248103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst