Provider Demographics
NPI:1669016523
Name:HINKSON, KATHLEEN ELISE
Entity Type:Individual
Prefix:MISS
First Name:KATHLEEN
Middle Name:ELISE
Last Name:HINKSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2731 V ST APT 5
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95818-1958
Mailing Address - Country:US
Mailing Address - Phone:310-346-6616
Mailing Address - Fax:
Practice Address - Street 1:3550 WATT AVE STE 7
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95821-2668
Practice Address - Country:US
Practice Address - Phone:310-346-6616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool