Provider Demographics
NPI:1023538204
Name:SINCLAIR, KYMBERLY CHRISTINE (RN)
Entity Type:Individual
Prefix:
First Name:KYMBERLY
Middle Name:CHRISTINE
Last Name:SINCLAIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 ALTA LOMA LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3918
Mailing Address - Country:US
Mailing Address - Phone:916-741-9850
Mailing Address - Fax:
Practice Address - Street 1:111 W SAINT JOHN ST STE 705
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95113-1106
Practice Address - Country:US
Practice Address - Phone:916-741-9850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA770014163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse