Provider Demographics
NPI:1790475374
Name:LOFTON, KIARA YONG
Entity Type:Individual
Prefix:
First Name:KIARA
Middle Name:YONG
Last Name:LOFTON
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 1:2804 ROMER BLVD
Mailing Address - Street 2:
Mailing Address - City:POLLOCK PINES
Mailing Address - State:CA
Mailing Address - Zip Code:95726-9242
Mailing Address - Country:US
Mailing Address - Phone:916-931-3270
Mailing Address - Fax:
Practice Address - Street 1:2804 ROMER BLVD
Practice Address - Street 2:
Practice Address - City:POLLOCK PINES
Practice Address - State:CA
Practice Address - Zip Code:95726-9242
Practice Address - Country:US
Practice Address - Phone:916-931-3270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst