Healthcare Provider Details

I. General information

NPI: 1669016523
Provider Name (Legal Business Name): MISS KATHLEEN ELISE HINKSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 11/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 WATT AVE STE 7
SACRAMENTO CA
95821-2668
US

IV. Provider business mailing address

2731 V ST APT 5
SACRAMENTO CA
95818-1958
US

V. Phone/Fax

Practice location:
  • Phone: 310-346-6616
  • Fax:
Mailing address:
  • Phone: 310-346-6616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: