Provider Demographics
NPI:1598077976
Name:KHILKO, NATALIA (PHD, LAC)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:KHILKO
Suffix:
Gender:F
Credentials:PHD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2602 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:REDWOOD CITY
Mailing Address - State:CA
Mailing Address - Zip Code:94061-3236
Mailing Address - Country:US
Mailing Address - Phone:650-839-1526
Mailing Address - Fax:650-839-1526
Practice Address - Street 1:2602 OHIO AVE
Practice Address - Street 2:
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94061-3236
Practice Address - Country:US
Practice Address - Phone:650-839-1526
Practice Address - Fax:650-839-1526
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13687171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist