Provider Demographics
NPI:1396181558
Name:WOO, KIMBERLEY (LAC, EDD)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:
Last Name:WOO
Suffix:
Gender:F
Credentials:LAC, EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3515 SIMSBURY CT
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92010-7035
Mailing Address - Country:US
Mailing Address - Phone:760-720-6961
Mailing Address - Fax:
Practice Address - Street 1:785 GRAND AVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-2370
Practice Address - Country:US
Practice Address - Phone:760-848-8646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-15
Last Update Date:2013-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist