Basic Information
| Provider Information | |||||||||
| NPI: | 1407279656 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WOHLANDER | ||||||||
| FirstName: | KIRBY | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.SW., L.C.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 15611 POMERADO RD STE 535 | ||||||||
| Address2: | |||||||||
| City: | POWAY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920642437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6199923290 | ||||||||
| FaxNumber: | 6197952664 | ||||||||
| Practice Location | |||||||||
| Address1: | 15611 POMERADO RD STE 535 | ||||||||
| Address2: | |||||||||
| City: | POWAY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920642437 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582791223 | ||||||||
| FaxNumber: | 8586798519 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2014 | ||||||||
| LastUpdateDate: | 05/12/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS 6835 | CA | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.