Provider Demographics
NPI:1669883450
Name:MONOSSON, KIMBERLEY (LMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:MONOSSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5144
Mailing Address - Street 2:
Mailing Address - City:PLAYA DEL REY
Mailing Address - State:CA
Mailing Address - Zip Code:90296-5144
Mailing Address - Country:US
Mailing Address - Phone:310-259-0236
Mailing Address - Fax:
Practice Address - Street 1:4201 LONG BEACH BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-2007
Practice Address - Country:US
Practice Address - Phone:562-988-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2014-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT51140106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist