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OCTAVIA MARIA KIMBLE
NPI 1205411725
Clinic/Center - Mental Health (Including Community Mental Health Center) in San Diego, CA

Active since March 16, 2021
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102(619) 515-2300 Get Directions Write a Review

NPPES record last updated: March 16, 2021. Verified against the NPPES registry weekly; last sync: October 04, 2026.

About Octavia Maria Kimble NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

OCTAVIA MARIA KIMBLE (NPI 1205411725) is an individual mental health (including community mental health center) provider in San Diego, California and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1205411725
Entity TypeIndividualFemale
Primary Taxonomy261QM0801X
Provider Legal NameOCTAVIA MARIA KIMBLE
Location Address823 GATEWAY CENTER WAYSan Diego, CA 92102-4541
Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 515-2300
Phone(619) 515-2300
Sole ProprietorYes
Enumeration DateMarch 16, 2021
NPPES CertifiedMarch 14, 2021
✔ NPI 1205411725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Mental Health (Including Community Mental Health Center)Ambulatory Health Care Facilities
Taxonomy Code261QM0801X
823 GATEWAY CENTER WAY, San Diego, CA 92102
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Other Names 1

Former Name (1)Octavia Kimble Bates

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUSAN KERMOIAN YASZAY NP
Nurse Practitioner (Family)
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
MR. ALEJANDRO R BASCON CERTIFIED
Counselor (Addiction (Substance Use Disorder))
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
BRITANY RODARTE
Dietitian, Registered
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
MISS KATIE LYNN WOOD LAADC
Counselor (Addiction (Substance Use Disorder))
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 876-4462
CARLY MOORE
Social Worker
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 906-4623
MYRNA ZAVALA MOLINA PA
Physician Assistant
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300
ANNE MARIA LEISTIKOW
Dental Hygienist
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2323
ANNA FADEM MFTI
Marriage & Family Therapist
823 GATEWAY CENTER WAY
SAN DIEGO, CA 92102
San Diego County (619) 515-2300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Octavia Kimble's NPI number?

The NPI number for Octavia Kimble is 1205411725. It was assigned to this individual provider in the NPPES registry on March 16, 2021. The provider is also known as Octavia Kimble Bates.

Where is Octavia Kimble located?

Octavia Kimble practices at 823 Gateway Center Way, San Diego, CA 92102. The listed phone number is (619) 515-2300.

What is Octavia Kimble's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Mental Health (Including Community Mental Health Center), with taxonomy code 261QM0801X.

When was this NPI record last updated?

The NPPES record for Octavia Kimble was last updated on March 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.