Provider Demographics
NPI:1487713392
Name:PHOEBUS, KAMBRA (ND)
Entity type:Individual
Prefix:DR
First Name:KAMBRA
Middle Name:
Last Name:PHOEBUS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 S DORA ST STE A
Mailing Address - Street 2:
Mailing Address - City:UKIAH
Mailing Address - State:CA
Mailing Address - Zip Code:95482-5736
Mailing Address - Country:US
Mailing Address - Phone:707-462-8628
Mailing Address - Fax:707-462-8628
Practice Address - Street 1:1081 S DORA ST STE A
Practice Address - Street 2:
Practice Address - City:UKIAH
Practice Address - State:CA
Practice Address - Zip Code:95482-5736
Practice Address - Country:US
Practice Address - Phone:707-462-8628
Practice Address - Fax:707-462-8628
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA204175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath