Provider Demographics
NPI:1730629379
Name:SILVA, KIMBERLYNN J (LMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLYNN
Middle Name:J
Last Name:SILVA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:KIMBERLYNN
Other - Middle Name:
Other - Last Name:SHAFFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT 123292
Mailing Address - Street 1:106 POLLASKY AVE STE D
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-1159
Mailing Address - Country:US
Mailing Address - Phone:559-203-3775
Mailing Address - Fax:559-326-0607
Practice Address - Street 1:106 POLLASKY AVE STE D
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-1159
Practice Address - Country:US
Practice Address - Phone:559-203-3775
Practice Address - Fax:559-326-0607
Is Sole Proprietor?:No
Enumeration Date:2017-03-01
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
CAAMFT107065106H00000X
CALMFT123292106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101Y00000XBehavioral Health & Social Service ProvidersCounselor