Provider Demographics
NPI:1164463006
Name:KEMBERLING, PATRICIA LYNN (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:LYNN
Last Name:KEMBERLING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:866 PLUMAS ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95991-4022
Mailing Address - Country:US
Mailing Address - Phone:530-790-7712
Mailing Address - Fax:530-790-7719
Practice Address - Street 1:866 PLUMAS ST
Practice Address - Street 2:SUITE D
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95991-4022
Practice Address - Country:US
Practice Address - Phone:530-790-7712
Practice Address - Fax:530-790-7719
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-10
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG49873174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G498730Medicare ID - Type Unspecified
CAA51491Medicare UPIN