Provider Demographics
NPI:1063893931
Name:SLIGAR, KIMBERLEY LUONG (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:LUONG
Last Name:SLIGAR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLEY
Other - Middle Name:
Other - Last Name:LUONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:405 W 5TH ST STE 2100
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92701-4599
Mailing Address - Country:US
Mailing Address - Phone:714-850-8589
Mailing Address - Fax:
Practice Address - Street 1:405 W 5TH ST STE 2100
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92701-4599
Practice Address - Country:US
Practice Address - Phone:714-850-8589
Practice Address - Fax:714-834-5939
Is Sole Proprietor?:No
Enumeration Date:2015-06-16
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA955661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical