| Doctor Name: | MS. KIM YVONNE ARCHULETTA |
| NPI Number: | 1033219720 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | LCS17446 |
| Business Practice Address: | 9220 Mountain Shadow Dr Lakeside, CA - 920405156 |
| Business Phone Number: | 6193909393 |
| Business Fax Number: | 6193901658 |
| Mailing Address: | Po Box 1522, LAKESIDE |
| State: | CA |
| Postal Code: | 920400912 |
| Phone Number: | 6197875724 |
| Fax Number: | 6193901658 |
| NPI Enumeration Date: | 09/23/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | LCS17446 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |