Provider Demographics
NPI:1346637659
Name:ERICKSON-MOREO, KALEN TAI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KALEN
Middle Name:TAI
Last Name:ERICKSON-MOREO
Suffix:
Gender:F
Credentials:PSYD
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Mailing Address - Street 1:2 UPPER RAGSDALE DR BLDG A
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-5736
Mailing Address - Country:US
Mailing Address - Phone:831-242-8392
Mailing Address - Fax:831-649-4966
Practice Address - Street 1:2 UPPER RAGSDALE DR BLDG A
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5736
Practice Address - Country:US
Practice Address - Phone:831-333-3040
Practice Address - Fax:831-886-3639
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY29442103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist