Provider Demographics
NPI:1669990784
Name:XIONG, KAOLEE
Entity type:Individual
Prefix:
First Name:KAOLEE
Middle Name:
Last Name:XIONG
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 1:1360 AMARANTH ST
Mailing Address - Street 2:
Mailing Address - City:PLUMAS LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95961-8719
Mailing Address - Country:US
Mailing Address - Phone:530-751-6182
Mailing Address - Fax:
Practice Address - Street 1:1360 AMARANTH ST
Practice Address - Street 2:
Practice Address - City:PLUMAS LAKE
Practice Address - State:CA
Practice Address - Zip Code:95961-8719
Practice Address - Country:US
Practice Address - Phone:530-751-6182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
94-2489666OtherASIAN PACIFIC COMMUNITY COUNSELING