Healthcare Provider Details

I. General information

NPI: 1366768228
Provider Name (Legal Business Name): KIMBERLY NATALIA FOSTER M.S., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2010
Last Update Date: 10/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5550 E 7TH ST
LONG BEACH CA
90804-4436
US

IV. Provider business mailing address

271 KENNEBEC AVE APT. 2
LONG BEACH CA
90803-5773
US

V. Phone/Fax

Practice location:
  • Phone: 562-277-1121
  • Fax:
Mailing address:
  • Phone: 562-277-1121
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberAC 13235
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: