Provider Demographics
NPI:1902870553
Name:KIRBY, CYNTHIA (MA, CCC-A)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:KIRBY
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34800 BOB WILSON DR
Mailing Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92134-1098
Mailing Address - Country:US
Mailing Address - Phone:619-532-6460
Mailing Address - Fax:619-532-6299
Practice Address - Street 1:34800 BOB WILSON DR
Practice Address - Street 2:NMCSD, ATTN: MEDICAL STAFF SERVICES
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92134-1098
Practice Address - Country:US
Practice Address - Phone:619-532-6460
Practice Address - Fax:619-532-6299
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU 946231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist