Provider Demographics
NPI:1952336802
Name:SAHAGUN, KIMBERLY S (DC)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:S
Last Name:SAHAGUN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22224 LA PALMA AVE
Mailing Address - Street 2:A
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92887-3819
Mailing Address - Country:US
Mailing Address - Phone:714-692-7138
Mailing Address - Fax:714-696-7767
Practice Address - Street 1:22224 LA PALMA AVE
Practice Address - Street 2:A
Practice Address - City:YORBA LINDA
Practice Address - State:CA
Practice Address - Zip Code:92887-3819
Practice Address - Country:US
Practice Address - Phone:714-692-7138
Practice Address - Fax:714-696-7767
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC29866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor