Provider Demographics
NPI:1194996215
Name:SANKEY, KATHLEEN A (OMD, LAC)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:A
Last Name:SANKEY
Suffix:
Gender:F
Credentials:OMD, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 W 64TH ST
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1126
Mailing Address - Country:US
Mailing Address - Phone:310-673-8225
Mailing Address - Fax:
Practice Address - Street 1:208 W 64TH ST
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1126
Practice Address - Country:US
Practice Address - Phone:310-673-8225
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC2660171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist