Provider Demographics
NPI:1023358926
Name:NEAL, KATHLEEN STROUP (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:STROUP
Last Name:NEAL
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:ANNE
Other - Last Name:STROUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:PO BOX 534
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93581-0534
Mailing Address - Country:US
Mailing Address - Phone:661-822-4402
Mailing Address - Fax:661-823-3362
Practice Address - Street 1:24900 HIGHWAY 202
Practice Address - Street 2:CALIFORNIA CORRECTIONAL INSTITUTION
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561
Practice Address - Country:US
Practice Address - Phone:661-557-5657
Practice Address - Fax:661-823-3362
Is Sole Proprietor?:No
Enumeration Date:2013-03-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23511103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist