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General NPI Number Information
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NPI Number | 1134544133
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Entity Type | Individual
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Provider Name | KIM EGAN
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Gender | Female
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 12183 LOCKSLEY LN
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City | AUBURN
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State | CA
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Zip | 95602-2004
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Country | US
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Telephone | 530-885-1961
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Fax | 530-889-1304
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Provider Business Mailing Address
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Address Line | PO BOX 6028
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City | AUBURN
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State | CA
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Zip | 95604-6028
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Country | US
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Telephone | 530-878-5166
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Fax | 916-797-8979
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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