Provider Demographics
NPI:1215341961
Name:RIOS-LAM, KIMBERLY (PSYD)
Entity type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:RIOS-LAM
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92336-3061
Mailing Address - Country:US
Mailing Address - Phone:909-684-0970
Mailing Address - Fax:
Practice Address - Street 1:8010 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92336-3061
Practice Address - Country:US
Practice Address - Phone:909-684-0970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD7848720390200000X
CAPSY32679103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program