Provider Demographics
NPI:1164893442
Name:KUGEL, URI (PHD)
Entity Type:Individual
Prefix:
First Name:URI
Middle Name:
Last Name:KUGEL
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 1:7462 BRENTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-4330
Mailing Address - Country:US
Mailing Address - Phone:510-213-8740
Mailing Address - Fax:
Practice Address - Street 1:5230 CARROLL CANYON RD
Practice Address - Street 2:STE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1779
Practice Address - Country:US
Practice Address - Phone:510-213-8740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28642103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical