Provider Demographics
NPI:1063612653
Name:KIMBALL, KATHRYN P (PHD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:P
Last Name:KIMBALL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 UNION ST
Mailing Address - Street 2:SUITE #5
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-4003
Mailing Address - Country:US
Mailing Address - Phone:415-828-5545
Mailing Address - Fax:
Practice Address - Street 1:2161 UNION ST
Practice Address - Street 2:SUITE #5
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4003
Practice Address - Country:US
Practice Address - Phone:415-828-5545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-20
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health