Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PSY 14579 | CA |
NPI | 1083781439 |
---|---|
Provider Name | Catharine Elizabeth Kibira |
First Address | Berkeley, CA 94707-8441 |
Second Address | Walnut Creek, CA 94596-5294 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2006 |
Last Update Date | 08/07/2007 |