| Doctor Name: | VANESSA ALEXANDRA KIMM |
| NPI Number: | 1013969435 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | A.R.N.P |
| License Number: | C-105998 |
| Business Practice Address: | 8781 Van Nuys Blvd Panorama City, CA - 914022401 |
| Business Phone Number: | 8188928349 |
| Business Fax Number: | 8182214103 |
| Mailing Address: | 8781 Van Nuys Blvd, PANORAMA CITY |
| State: | CA |
| Postal Code: | 914022401 |
| Phone Number: | 8188928349 |
| Fax Number: | 8182214103 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 03/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | C-105998 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |