DR. KIMBERLY HAGEN HAGEN


Address: 12021 Wilmington Ave, Trailer 6, Los Angeles, CA 90059-3019
Phone: 3106686428

DR. KIMBERLY HAGEN HAGEN (NPI# 1245369990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1245369990
Entity Type Individual
Full Name DR. KIMBERLY HAGEN HAGEN
Credential PH.D.
Practice Address 12021 Wilmington Ave
Trailer 6
Los Angeles
CA 90059-3019
Mailing Address 400 Corporate Pointe
Suite 300
Culver City
CA 90230-7615
Practice Telephone 3106686428
Mailing Telephone 3106259256
Enumeration Date 2007-03-05
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TC0700X Psychologist
Specialization: Clinical
16798 CA Behavioral Health & Social Service Providers

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Office Location

Street Address 12021 WILMINGTON AVE
TRAILER 6
City LOS ANGELES
State CA
Zip Code 90059-3019

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NPI Name Taxonomy Address Enumeration
1750351300 Gangadarshni Chandramohan Pediatrics 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2006-01-25
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1114418928 Exodus Recovery, Inc. Community/Behavioral Health 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2018-05-29
1043759855 Los Angeles County Department of Mental Health Clinic/Center 12021 Wilmington Ave, Los Angeles, CA 90059 2017-02-14
1053855064 Maria Casarez-romero Rehabilitation Practitioner 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2016-12-09
1295279453 Kelsey Collins Marriage & Family Therapist 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2016-12-07
1639628035 Stella Cuomo Student in an Organized Health Care Education/Training Program 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2016-09-26
1821443995 Patanya Matthews Counselor 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2016-04-26
1043677289 Kita Stovall Nurse Practitioner 12021 Wilmington Ave, Los Angeles, CA 90059 2016-01-19
1417314741 Noele Le Flore Nurse Practitioner 12021 Wilmington Ave, Los Angeles, CA 90059-3019 2016-01-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1235759788 Juan Jimenez Jr. Technician, Pathology 1860 E 120th St, Los Angeles, CA 90059 2020-04-24
1538717780 Donald O Nwanze Pharmacist Mlk Outpatient Center (pharmacy), 1670 East 120th Street, Los Angeles, CA 90059 2019-08-30
1295391050 Sheela Hoyle Counselor 836 East Saucer Lane, Los Angeles, CA 90059 2019-05-16
1750852471 Carlos Tovar Sr. Community Health Worker 1720 E 120st, Los Angeles, CA 90059 2018-12-06
1699293910 Amy Caryn Bolenbaugh Recreation Therapist 1720 E 120th Street, Los Angeles, CA 90059 2017-09-07
1417475757 Scott Lee Jones Recreation Therapist Augustus F. Hawkins, 1720 E. 120th Street, Rm. 2196, Los Angeles, CA 90059 2017-09-07
1881118859 Darlene Renee Tillman Speech-Language Pathologist 1670 E 120th Strret, Los Angeles, CA 90059 2017-08-01
1609306430 Valda Therese Flores Registered Nurse 1670 E. 120th Street, Los Angeles, CA 90059 2017-06-14
1093244006 Bongsill Chung Registered Nurse 1670 East 120th St, Los Angeles, CA 90059 2017-06-05
1730573395 Apollonia Godoy Registered Nurse 1670 E. 120th St, 4th Floor, Module A, Los Angeles, CA 90059 2015-03-22
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Taxonomy Information

Taxonomy Code 103TC0700X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Clinical

Taxonomy Definition

Definition to come...

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1194330274 Marilyn S Zweifach Psychologist 3606 Barry Avenue, Los Angeles, CA 90066 2020-09-15
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Competitor

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City LOS ANGELES
Zip Code 90059

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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