Provider Demographics
NPI:1033321526
Name:CRAIG KAIN, PHD, PSYCHOLOGICAL SERVICES, APC
Entity Type:Organization
Organization Name:CRAIG KAIN, PHD, PSYCHOLOGICAL SERVICES, APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:KAIN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:562-987-1766
Mailing Address - Street 1:3416 EAST BROADWAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90803
Mailing Address - Country:US
Mailing Address - Phone:562-987-1766
Mailing Address - Fax:
Practice Address - Street 1:3416 EAST BROADWAY
Practice Address - Street 2:SUITE A
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90803
Practice Address - Country:US
Practice Address - Phone:562-987-1766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14664103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty