Provider Demographics
NPI:1114011723
Name:KAYE, JEFFREY S (PHD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:KAYE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 ACAPULCO COURT
Mailing Address - Street 2:
Mailing Address - City:NOVATO
Mailing Address - State:CA
Mailing Address - Zip Code:94949-6365
Mailing Address - Country:US
Mailing Address - Phone:415-382-8762
Mailing Address - Fax:415-382-6252
Practice Address - Street 1:844 CALIFORNIA STREET
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-2315
Practice Address - Country:US
Practice Address - Phone:415-362-8262
Practice Address - Fax:415-382-6252
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15476103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAS86226Medicare UPIN
CAOPL154760Medicare ID - Type UnspecifiedPSYCHOLOGIST