Provider Demographics
NPI:1780878520
Name:CURTIS, KIMBERLY MAE
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MAE
Last Name:CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:MAE
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39275 LIBERTY ST STE D-12
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538-1519
Mailing Address - Country:US
Mailing Address - Phone:510-742-3904
Mailing Address - Fax:510-742-3912
Practice Address - Street 1:39275 LIBERTY ST STE D-12
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538-1519
Practice Address - Country:US
Practice Address - Phone:510-742-3904
Practice Address - Fax:510-742-3912
Is Sole Proprietor?:No
Enumeration Date:2007-09-05
Last Update Date:2009-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor