Provider Demographics
NPI:1326632951
Name:KAITLYN KUO AND ASSOCIATES PSYCHOLOGY CORP
Entity Type:Organization
Organization Name:KAITLYN KUO AND ASSOCIATES PSYCHOLOGY CORP
Other - Org Name:SOULIDARITY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAO CHIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUO
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:949-229-1314
Mailing Address - Street 1:1968 S COAST HWY STE 1493
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-3681
Mailing Address - Country:US
Mailing Address - Phone:949-229-1314
Mailing Address - Fax:
Practice Address - Street 1:1968 S COAST HWY STE 1493
Practice Address - Street 2:
Practice Address - City:LAGUNA BEACH
Practice Address - State:CA
Practice Address - Zip Code:92651-3681
Practice Address - Country:US
Practice Address - Phone:949-229-1314
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-24
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty