Kimbo Drug & Alcohol Rehabilitation Services

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Legal business name

KIMBO DRUG & ALCOHOL REHABILITATION SERVICES

Practice address

407 N Avalon Blvd
Wilmington, CA 90744-5803

Phone

(310) 549-5532

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Kester Jackson Oudney, LICENSE PSYCH TECH

Title

Program Director

Phone

(310) 549-5532

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1760665582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907445803",
            "telephone_number": "310-549-5532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N AVALON BLVD",
            "city": "WILMINGTON",
            "state": "CA",
            "postal_code": "907445803",
            "telephone_number": "310-549-5532"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBO DRUG & ALCOHOL REHABILITATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "OUDNEY",
        "authorized_official_first_name": "KESTER",
        "authorized_official_middle_name": "JACKSON",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "310-549-5532",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICENSE PSYCH TECH"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Negin Kahen, PA-C
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• Andrew Kim, D.D.S.
• Kimbo Medical Distributor
• Marilyn Kleist, LMFT
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• Paul J Krynen, D.C.
• Antoinette Laura, NP

• Addiction (Substance Use Disorder) Counselor in Wilmington, CA
• Providers in Wilmington, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.