Provider Demographics
NPI:1295872323
Name:KIRBY, PAULINE V (RN, LIC AC)
Entity type:Individual
Prefix:
First Name:PAULINE
Middle Name:V
Last Name:KIRBY
Suffix:
Gender:F
Credentials:RN, LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 138
Mailing Address - Street 2:
Mailing Address - City:CARMEL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93924-0138
Mailing Address - Country:US
Mailing Address - Phone:831-659-1733
Mailing Address - Fax:831-659-8665
Practice Address - Street 1:3 PASO CRESTA
Practice Address - Street 2:
Practice Address - City:CARMEL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93924
Practice Address - Country:US
Practice Address - Phone:831-659-1733
Practice Address - Fax:831-659-8665
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC 1194171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist