Individual
KIMBERLY R FAUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1155 SOUTH MAIN STREET, SUITE 101, WILLITS, CA 95490
(707) 456-1100
(707) 456-1101
Mailing address
1155 SOUTH MAIN STREET, SUITE 101, WILLITS, CA 95490
(707) 456-1100
(707) 456-1101
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G74987
CA
207VG0400X
Gynecology Physician
MD00036004
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039592
LABOR & INDUSTRY
WA
01
—
4821FA
BLUE SHIELD
WA
05
—
8232035
—
WA
01
—
P00239584
RAILROAD MEDICARE
—
01
—
US5553733
AETNA/USHC SPECIALIST
WA
Enumeration date
08/30/2006
Last updated
04/25/2014
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