OCTAVIA MARIA KIMBLE NPI 1205411725

NPI Information

NPI: 1205411725
Provider Name: OCTAVIA MARIA KIMBLE
Classification: Clinic/Center - 261QM0801X
Entity Type: Individual

Specialization: Mental Health (Including Community Mental Health Center)

PECOS Registration: Yes

Address:
823 GATEWAY CENTER WAY
SAN DIEGO, CA
ZIP 92102
Phone: (619) 515-2300
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Octavia Maria Kimble is a mental health (including community mental health center) clinic center in San Diego, CA. Octavia Maria Kimble NPI is 1205411725. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

823 GATEWAY CENTER WAY
SAN DIEGO, CA
ZIP 92102-541
Phone: (619) 515-2300

The NPI 1205411725 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS).

The enumeration date for this NPI number is 3/16/2021 and was last updated on 3/16/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)		CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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