Individual
MRS. KIMBERLY PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1941 JOHNSON, SUITE 301, SAN LUIS OBISPO, CA 93401-4175
(805) 739-3474
Mailing address
504 PLAZA DR, SANTA MARIA, CA 93454-6917
(805) 739-3474
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
10541
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB220902
MEDICARE ID
CA
Enumeration date
07/20/2006
Last updated
01/25/2017
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