Provider Demographics
NPI:1306028204
Name:KIFFER, JAMES J (PHD CLINICAL PSYCHOL)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:J
Last Name:KIFFER
Suffix:
Gender:M
Credentials:PHD CLINICAL PSYCHOL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:271 PUTI TAI NOBIO ST
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA HEIGHTS
Mailing Address - State:GU
Mailing Address - Zip Code:96913
Mailing Address - Country:US
Mailing Address - Phone:671-637-8929
Mailing Address - Fax:671-632-3000
Practice Address - Street 1:271 PUTI TAI NOBIO ST
Practice Address - Street 2:
Practice Address - City:BARRIGADA HEIGHTS
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-637-8929
Practice Address - Fax:671-632-3000
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUCP10103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist