Individual
AMBER NICOLE KINGSLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
1012 CARVER RD, MODESTO, CA 95350-4732
(209) 549-2215
(209) 549-2216
Mailing address
1012 CARVER RD, MODESTO, CA 95350-4732
(209) 549-2215
(209) 549-2216
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
31121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4031738
MEDICAL
CA
01
—
CM101A
PTAN
CA
01
—
DC0311210
BLUE SHIELD PIN
CA
01
—
DC31121
CHIROPRACTIC LICENSE
CA
Enumeration date
02/04/2009
Last updated
11/29/2025
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