Provider Demographics
NPI:1447560610
Name:MAGUIRE SONN, KATHLEEN MARIE (LM)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:MAGUIRE SONN
Suffix:
Gender:F
Credentials:LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 RAINERI DR
Mailing Address - Street 2:
Mailing Address - City:ARCATA
Mailing Address - State:CA
Mailing Address - Zip Code:95521-9654
Mailing Address - Country:US
Mailing Address - Phone:707-445-0420
Mailing Address - Fax:
Practice Address - Street 1:2051 OLD ARCATA RD
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:CA
Practice Address - Zip Code:95524-9033
Practice Address - Country:US
Practice Address - Phone:707-826-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2010-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALM279176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife