1780473595 NPI number — KIMBERLEY PEACOCK TURNER MA, BCBA

Table of content: KIMBERLEY PEACOCK TURNER MA, BCBA (NPI 1780473595)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780473595 NPI number — KIMBERLEY PEACOCK TURNER MA, BCBA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TURNER
Provider First Name:
KIMBERLEY
Provider Middle Name:
PEACOCK
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, BCBA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780473595
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/24/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
362 E CATAWBA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MOORESVILLE
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28115-2659
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-677-8739
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1333 S MAYFLOWER AVE
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
MONROVIA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
91016-4066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
818-241-6780
Provider Business Practice Location Address Fax Number:
888-588-2752
Provider Enumeration Date:
05/06/2025

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X , with the licence number:  3582 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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