Provider Demographics
NPI:1285046482
Name:SIPANYA, KHAMKEUA
Entity type:Individual
Prefix:MRS
First Name:KHAMKEUA
Middle Name:
Last Name:SIPANYA
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:SIPANYA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:9745 JOLIET CIR
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-0661
Mailing Address - Country:US
Mailing Address - Phone:720-227-5039
Mailing Address - Fax:
Practice Address - Street 1:1537 ALTON ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80010-1712
Practice Address - Country:US
Practice Address - Phone:303-923-2920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-22
Last Update Date:2014-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health