Provider Demographics
NPI:1215049689
Name:KINYON, JOANNE KATHLEEN (ATC)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:KATHLEEN
Last Name:KINYON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1015 CADILLAC WAY
Mailing Address - Street 2:APT 202
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-8508
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1015 CADILLAC WAY
Practice Address - Street 2:APT 202
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-8508
Practice Address - Country:US
Practice Address - Phone:408-983-1166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2009-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor