Provider Demographics
NPI:1811712839
Name:ENLIGHTEN HOLISTIC HEALTH WITH KITTY WOO HAM, FNP
Entity type:Organization
Organization Name:ENLIGHTEN HOLISTIC HEALTH WITH KITTY WOO HAM, FNP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:KITTY WOO
Authorized Official - Middle Name:
Authorized Official - Last Name:HAM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, FNP
Authorized Official - Phone:512-762-7089
Mailing Address - Street 1:9300 CEDAR CREST DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2721
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9300 CEDAR CREST DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2721
Practice Address - Country:US
Practice Address - Phone:512-900-9668
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-15
Last Update Date:2024-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Multi-Specialty