Provider Demographics
NPI:1982823803
Name:KIENG, SOKUNTHEA MELODY
Entity Type:Individual
Prefix:MRS
First Name:SOKUNTHEA
Middle Name:MELODY
Last Name:KIENG
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 1:8780 RIDEABOUT LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-3742
Mailing Address - Country:US
Mailing Address - Phone:858-538-9482
Mailing Address - Fax:
Practice Address - Street 1:2359 ULRIC ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-6402
Practice Address - Country:US
Practice Address - Phone:858-268-4933
Practice Address - Fax:858-268-0244
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health