Provider Demographics
NPI:1235287574
Name:KADIN, STEVEN M (PHD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:M
Last Name:KADIN
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 1:3163 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5957
Mailing Address - Country:US
Mailing Address - Phone:805-541-1888
Mailing Address - Fax:805-781-9045
Practice Address - Street 1:1264 HIGUERA ST STE 206
Practice Address - Street 2:
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-3129
Practice Address - Country:US
Practice Address - Phone:805-546-3774
Practice Address - Fax:805-781-9045
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY14766103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACP14766Medicare ID - Type Unspecified