Provider Demographics
NPI:1588048995
Name:HERRERA, KIMBERLY OPHELIA (LMFT)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:OPHELIA
Last Name:HERRERA
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 1:306 E LANSING WAY
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93704-4106
Mailing Address - Country:US
Mailing Address - Phone:209-480-9553
Mailing Address - Fax:
Practice Address - Street 1:1478 W. SHAW AVE.
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-3607
Practice Address - Country:US
Practice Address - Phone:559-449-3419
Practice Address - Fax:877-396-3157
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-15
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA116058106H00000X, 106H00000X
CALMFT116058106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist