person
Kimberly Lavonne Self, CADC-1
Addiction (Substance Use Disorder) Counselor in Santa Ana, California
NPI 1487123873

Kimberly Lavonne Self is an Addiction (Substance Use Disorder) Counselor based in Anaheim, CA and is specialized in Addiction (Substance Use Disorder). Kimberly Lavonne Self practices in Santa Ana, CA and has the professional credentials of CADC-1. The NPI Number for Kimberly Lavonne Self is 1487123873 and holds a License No. C059050818 (California).

The current practice location address for Kimberly Lavonne Self is 1207 E Fruit St, Santa Ana, CA and can be reached out via phone at 714-953-9373.

Location: 1207 E Fruit St, Santa Ana, CA, 92804-2075
person
Provider Profile Details
NPI Number
1487123873
Provider Name
Kimberly Lavonne Self
Credential
CADC-1
Provider Entity Type
Individual
Gender
Female
Address
1207 E Fruit St, Santa Ana, CA, 92804-2075
Phone Number
714-953-9373
Fax Number
Provider Enumeration Date
11/15/2018
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
0000 05 CA
institution
Provider Business Practice Location Address Details
Address
1207 E Fruit St
City
State
Zip
92701-4206
Phone Number
714-953-9373
Fax Number
person
Provider Business Mailing Address Details
Address
1207 E Fruit St
City
State
Zip
92701-4206
Phone Number
714-953-9373
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
C059050818 (California)
Definition
Definition to come...
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