Provider Demographics
NPI:1427321801
Name:CATHERINA, KIMBERLY ANN (DC)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:CATHERINA
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 1:105 E JONES ST
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-5114
Mailing Address - Country:US
Mailing Address - Phone:805-310-3678
Mailing Address - Fax:805-354-0214
Practice Address - Street 1:105 E JONES ST
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-5114
Practice Address - Country:US
Practice Address - Phone:805-310-3678
Practice Address - Fax:805-354-0214
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC32197111N00000X
CA32197111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor