Provider Demographics
NPI:1538963889
Name:CARR, KIMBERLINA ANN
Entity type:Individual
Prefix:
First Name:KIMBERLINA
Middle Name:ANN
Last Name:CARR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W BULLARD AVE APT 180
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0812
Mailing Address - Country:US
Mailing Address - Phone:559-477-8154
Mailing Address - Fax:
Practice Address - Street 1:90 W ASHLAN AVE STE 100
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-5627
Practice Address - Country:US
Practice Address - Phone:559-477-8154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator