Provider Demographics
NPI:1881329159
Name:FARIA, KIMBERLY (GC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:FARIA
Suffix:
Gender:F
Credentials:GC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6308 NW 84TH PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-4625
Mailing Address - Country:US
Mailing Address - Phone:707-771-0397
Mailing Address - Fax:
Practice Address - Street 1:105 W 8TH AVE STE 454E
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2318
Practice Address - Country:US
Practice Address - Phone:509-474-6287
Practice Address - Fax:509-474-3811
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS