Provider Demographics
NPI:1407197387
Name:KIRBY, JAMES VINCENT II (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:VINCENT
Last Name:KIRBY
Suffix:II
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-0908
Mailing Address - Country:US
Mailing Address - Phone:559-779-9864
Mailing Address - Fax:559-298-3106
Practice Address - Street 1:341 CHERRY LN
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-0908
Practice Address - Country:US
Practice Address - Phone:559-779-9864
Practice Address - Fax:559-298-3106
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-02
Last Update Date:2013-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22941104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker