Provider Demographics
NPI:1275678674
Name:ROWERDINK, KIMBERLY DALE
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:DALE
Last Name:ROWERDINK
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 1:18900 LAHEY ST
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91326-2335
Mailing Address - Country:US
Mailing Address - Phone:916-262-5279
Mailing Address - Fax:
Practice Address - Street 1:23860 HAWTHORNE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-8201
Practice Address - Country:US
Practice Address - Phone:310-791-3064
Practice Address - Fax:310-791-3084
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist