Kimberly Abanaka
Individual provider Active NPI Marriage & Family Therapist · Oakland, CA
NPI 1255949400 · NPPES record last updated Jun 5, 2023
Key facts
- NPI
- 1255949400
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- 134681 (CA)
- Practice address
- 2828 Ford St
Oakland, CA 94601-2114 - Phone
- (510) 268-3770
- NPI assigned
- Jul 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 134681 | CA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Homeless Children'S Network | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Marriage & Family Therapist | 106H00000X | 134681 | CA | Yes |
Addresses
Primary practice location
2828 Ford St
Oakland, CA 94601-2114
Mailing address
2828 Ford St
Oakland, CA 94601-2114
Other providers in Oakland, CA
- David S. Aaronson
- Marilyn Ababio
- Louisa Abada
- Regina Abadajos
- Patricia Abadesco
- Briana Mishell Abarca Climaco
- Jennifer Abarca
- Miriam Abarca
- Donna M. Abare
- Paul-Andre Charles Abboud
All providers in Oakland, CA · Marriage & Family Therapist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.