KIRBY NALUCK KHOONSRIVONG (NPI# 1265679591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265679591 |
| Entity Type | Individual |
| Full Name | KIRBY NALUCK KHOONSRIVONG |
| Practice Address |
10309 Big Oak Cir Stockton CA 95209-4560 |
| Practice Telephone | 2095132680 |
| Mailing Telephone | 2095132680 |
| Enumeration Date | 2009-01-08 |
| Last Update Date | 2009-01-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Street Address |
10309 BIG OAK CIR |
| City | STOCKTON |
| State | CA |
| Zip Code | 95209-4560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104272954 | William Luther Bennett | Pharmacist | 1131 Sunnyoak Way, Stockton, CA 95209 | 2016-05-11 |
| 1548686769 | Roland Rillamas Lagpacan | Pharmacist | 3131 West Hammer Lane, Stockton, CA 95209 | 2014-03-12 |
| 1346599677 | Luis Leyva Garcia | Marriage & Family Therapist | 1755 West Hammer Lane, Stockton, CA 95209 | 2012-08-31 |
| 1942506233 | Donna Lynn Peterson | Dentist | 9409 Thornton Rd, Stockton, CA 95209 | 2011-02-03 |
| 1386969798 | Miusotic Zaragoza | Social Worker | 1755 W. Hammer Lane Suite 8, Latino Behavioral Health, Stockton, CA 95209 | 2010-03-30 |
| 1497988844 | Marissa Elizabeth Preciado | Counselor | 10147 River Falls Cir, Stockton, CA 95209 | 2009-09-02 |
| 1316190796 | Sutter Gould Medical Foundation | Clinic/Center | 8011 Don Ave, Stockton, CA 95209 | 2008-10-29 |
| 1881845790 | Gary Earl Fiscus | Dentist | 4565 Quail Lakes Drive, Suite A-2, Stockton, CA 95209 | 2008-10-09 |
| 1326225665 | Shirley's Care Home Inc | Intermediate Care Facility, Mentally Retarded | 2330 Shropshire Dr, Stockton, CA 95209 | 2008-01-29 |
| 1134272727 | Joanie Mc Culloch | Homeopath | 8807 Thornton Rd, Ste. P, Stockton, CA 95209 | 2007-01-19 |
| Find all providers in zip 95209 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893155 | Tracey Black | Counselor | 130 W Flora St, Stockton, CA 95202-1636 | 2020-08-25 |
| 1699305508 | Juan Robles | Counselor | 1947 N California St # 95204, Stockton, CA 95204-6029 | 2020-01-20 |
| 1831730555 | Ronnie C Murray | Counselor | 1947 North California Street, Stockton, CA 95204 | 2019-10-03 |
| 1821648353 | Kaye Lynn Scott-roy | Counselor | 285 H Rd, Stockton, KS 67669-8889 | 2019-09-17 |
| 1760049043 | Jay Frank Williams | Counselor | 1105 N El Dorado St, Stockton, CA 95202-1305 | 2019-05-22 |
| 1184105462 | Rachelle Diane Wilson | Counselor | 2733 N Sutter St, Stockton, CA 95204-4548 | 2018-08-24 |
| 1568943835 | Heather Lynn Rogers | Counselor | 3990 Black Butte Cir, Stockton, CA 95209-3500 | 2018-08-24 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1760995781 | Dana Lamont Harris | Counselor | 2833 Buckner Ct, Stockton, CA 95207-2302 | 2017-11-13 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.