Provider Demographics
NPI:1407279656
Name:WOHLANDER, KIRBY (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:KIRBY
Middle Name:
Last Name:WOHLANDER
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15611 POMERADO RD STE 535
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2437
Mailing Address - Country:US
Mailing Address - Phone:619-992-3290
Mailing Address - Fax:619-795-2664
Practice Address - Street 1:15611 POMERADO RD STE 535
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:858-279-1223
Practice Address - Fax:858-679-8519
Is Sole Proprietor?:No
Enumeration Date:2014-01-23
Last Update Date:2017-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 68351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical