Provider Demographics
NPI:1518198258
Name:KIRLIN, ANNIE M (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ANNIE
Middle Name:M
Last Name:KIRLIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25391 NELLIE GAIL RD
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5744
Mailing Address - Country:US
Mailing Address - Phone:949-643-9100
Mailing Address - Fax:949-643-9310
Practice Address - Street 1:4199 CAMPUS DR
Practice Address - Street 2:SUITE E
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92612-4684
Practice Address - Country:US
Practice Address - Phone:949-737-5460
Practice Address - Fax:949-737-5467
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program