MS. KIMBERLY MICHONNE CLARK-HOLLOWAY NPI 1952827628

NPI Information

NPI: 1952827628
Provider Name: MS. KIMBERLY MICHONNE CLARK-HOLLOWAY
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
12917 CERISE AVE
HAWTHORNE, CA
ZIP 90250
Phone: (310) 675-4431
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MS. Kimberly Michonne Clark-holloway is an addiction (substance use disorder) counselor in Hawthorne, CA. MS. Kimberly Michonne Clark-holloway NPI is 1952827628. 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:

12917 CERISE AVE
HAWTHORNE, CA
ZIP 90250-520
Phone: (310) 675-4431
Fax: (310) 675-4434

The enumeration date for this NPI number is 8/15/2017 and was last updated on 7/21/2022.

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	101YA0400X	Counselor	Addiction (Substance Use Disorder)	R1891014	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

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