Provider Demographics
NPI:1528179009
Name:KIRSHNIT, CAROL ELIZABETH (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ELIZABETH
Last Name:KIRSHNIT
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 74182
Mailing Address - Street 2:
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95617-5182
Mailing Address - Country:US
Mailing Address - Phone:916-217-7762
Mailing Address - Fax:530-758-4239
Practice Address - Street 1:2727 DEL RIO PL
Practice Address - Street 2:SUITE C
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-7729
Practice Address - Country:US
Practice Address - Phone:916-217-7762
Practice Address - Fax:530-758-4239
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14580103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical