Provider Demographics
NPI:1821148842
Name:KOBYLECKA, MONIKA (LAC)
Entity Type:Individual
Prefix:
First Name:MONIKA
Middle Name:
Last Name:KOBYLECKA
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25407 SILVER CREST CT
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-3346
Mailing Address - Country:US
Mailing Address - Phone:661-904-6919
Mailing Address - Fax:661-310-3676
Practice Address - Street 1:25407 SILVER CREST CT
Practice Address - Street 2:
Practice Address - City:SANTA CLARITA
Practice Address - State:CA
Practice Address - Zip Code:91350-3346
Practice Address - Country:US
Practice Address - Phone:661-904-6919
Practice Address - Fax:661-310-3676
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC9622171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist