Kimberly Ann Dougherty, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

CAPSY10076 Issued in CA

Practice address

5151 N Palm Ave
#890
Fresno, CA 93704-2208

Phone

(559) 225-8960

Fax

(559) 225-8901

NPI assigned

Feb 5, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Kimberly Ann Mallek Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285773572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 N PALM AVE",
            "address_2": "#890",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042208",
            "telephone_number": "559-225-8960",
            "fax_number": "559-225-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 N PALM AVE",
            "address_2": "#890",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937042208",
            "telephone_number": "559-225-8960",
            "fax_number": "559-225-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "CAPSY10076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "MALLEK",
            "middle_name": "ANN",
            "prefix": "MRS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karanpreet Kaur Dosanjh, FNP-C
• Abhay N Doshi
• Omejia Dotson
• Kenneth E. Doty, D.D.S.
• Samuel Doty
• Simon Francis Dougherty, PA-C
• Douglas O. Charters
• Douglas R Halloran DDS Inc
• Douglas R Swinehart M D Professional Corporation
• Douglas S. Stanley, M.D., Inc.

• Psychologist in Fresno, CA
• Providers in Fresno, CA by specialty
• Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.