Provider Demographics
NPI:1386142164
Name:KIMBERLY CLAPP MARRIAGE AND FAMIY THERAPIST
Entity type:Organization
Organization Name:KIMBERLY CLAPP MARRIAGE AND FAMIY THERAPIST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:CLAPP
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:310-403-9180
Mailing Address - Street 1:2925 4TH ST APT 29
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90405-5519
Mailing Address - Country:US
Mailing Address - Phone:310-403-9180
Mailing Address - Fax:
Practice Address - Street 1:3301 OCEAN PARK BLVD STE 104
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90405-3270
Practice Address - Country:US
Practice Address - Phone:310-403-9180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47049106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty