Provider Demographics
NPI:1225824725
Name:MAI, KIMBERLY UYEN (AMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:UYEN
Last Name:MAI
Suffix:
Gender:
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX DK
Mailing Address - Street 2:
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95031-0409
Mailing Address - Country:US
Mailing Address - Phone:408-813-0234
Mailing Address - Fax:
Practice Address - Street 1:137 E HAMILTON AVE STE 203
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-0244
Practice Address - Country:US
Practice Address - Phone:408-384-8332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-19
Last Update Date:2025-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAMFT154145106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist