Kimberly Lauren Wimer, M.S,BCBA

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

12147471 Issued in CA

Practice address

2155 Chicago Ave Ste 203
Riverside, CA 92507-2209

Phone

(951) 357-6926

NPI assigned

May 5, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1557014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615334400000",
    "number": "1366007452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18726 S WESTERN AVE STE 408",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902483858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 CHICAGO AVE STE 203",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925072209",
            "telephone_number": "951-357-6926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIMER",
        "first_name": "KIMBERLY",
        "middle_name": "LAUREN",
        "credential": "M.S,BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-05",
        "last_updated": "2021-03-10",
        "certification_date": "2021-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "12147471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Diane Marie Wilson, RN
• Porsha Wilson
• Tara L Wilson, MD
• Xiomara Caridad Wilson
• Julia Alejandra Wilton
• Marjorie Teresa Wimmer, MD
• Tammy Windeknecht, FNP-C
• Anna Maritzha Windell
• Mary Windham, LVN
• Tiara Winding

• Behavior Analyst in Riverside, CA
• Providers in Riverside, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2021; 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.