Provider Demographics
NPI:1134421647
Name:PEIRANO, KIMBERLEY ROSE (DACM, LAC)
Entity type:Individual
Prefix:DR
First Name:KIMBERLEY
Middle Name:ROSE
Last Name:PEIRANO
Suffix:
Gender:F
Credentials:DACM, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:503 D ST STE 4
Mailing Address - Street 2:
Mailing Address - City:SAN RAFAEL
Mailing Address - State:CA
Mailing Address - Zip Code:94901-3864
Mailing Address - Country:US
Mailing Address - Phone:415-366-6708
Mailing Address - Fax:
Practice Address - Street 1:503 D ST STE 4
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94901-3864
Practice Address - Country:US
Practice Address - Phone:415-366-6708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-03
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13833171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist