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MR. KIM LYNETTE BRAXTON LCSW

Clinical >> Social Worker >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1699809707

Individual Registrant:
MR. KIM LYNETTE BRAXTON LCSW
Gender: F
Not Sole Proprietor

Location and contact information for practice:
3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE PATTON, CA 92369 US
Tel: 909-425-7000  Fax: 909-620-9793

Contact information for business:
3102 E. HIGHLAND AVENUE MEDICAL STAFF OFFICE PATTON, CA 92369 US
Tel: (90-9) -425-7000  Fax: --

Registration Information:
NPI: 1699809707
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N1041C0700XBehavioral Health & Social Service Providers
Social Worker
Clinical
CA23535
Y1041C0700XBehavioral Health & Social Service Providers
Social Worker

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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