Provider Demographics
NPI:1225697543
Name:DR. EMILY N. KIERCE, PSYCHOLOGIST, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:DR. EMILY N. KIERCE, PSYCHOLOGIST, A PROFESSIONAL CORPORATION
Other - Org Name:SENTIERO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILY
Authorized Official - Middle Name:N
Authorized Official - Last Name:KIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-930-9060
Mailing Address - Street 1:402 W BROADWAY STE 1925
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92101-8505
Mailing Address - Country:US
Mailing Address - Phone:619-930-9060
Mailing Address - Fax:619-930-9060
Practice Address - Street 1:402 W BROADWAY STE 1925
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-8505
Practice Address - Country:US
Practice Address - Phone:619-930-9060
Practice Address - Fax:619-930-9060
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-10
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty