Provider Demographics
NPI:1316953003
Name:EHRLICH, KIMBERLY KAY (LMFT)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:KAY
Last Name:EHRLICH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2819 CROW CANYON RD
Mailing Address - Street 2:SUITE 219E
Mailing Address - City:SAN RAMON
Mailing Address - State:CA
Mailing Address - Zip Code:94583-1655
Mailing Address - Country:US
Mailing Address - Phone:925-301-6523
Mailing Address - Fax:
Practice Address - Street 1:2819 CROW CANYON RD
Practice Address - Street 2:SUITE 219E
Practice Address - City:SAN RAMON
Practice Address - State:CA
Practice Address - Zip Code:94583-1655
Practice Address - Country:US
Practice Address - Phone:925-301-6523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC40502106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist