Provider Demographics
NPI:1396293387
Name:KIMBERLEY QUINLAN A MARRIAGE AND FAMILY THERAPY CORPORATION
Entity type:Organization
Organization Name:KIMBERLEY QUINLAN A MARRIAGE AND FAMILY THERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMFT
Authorized Official - Prefix:MRS
Authorized Official - First Name:KIMBERLEY
Authorized Official - Middle Name:JAYNE
Authorized Official - Last Name:QUINLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:818-452-3510
Mailing Address - Street 1:23801 CALABASAS RD STE 2036
Mailing Address - Street 2:
Mailing Address - City:CALABASAS
Mailing Address - State:CA
Mailing Address - Zip Code:91302-3462
Mailing Address - Country:US
Mailing Address - Phone:818-452-3510
Mailing Address - Fax:
Practice Address - Street 1:23801 CALABASAS RD STE 2036
Practice Address - Street 2:
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-3462
Practice Address - Country:US
Practice Address - Phone:818-452-3510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC#78448106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty