Provider Demographics
NPI:1407051394
Name:GUNZ, KATHY VERNON (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:VERNON
Last Name:GUNZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 FAIR OAKS BLVD
Mailing Address - Street 2:SUITE 190A
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-5533
Mailing Address - Country:US
Mailing Address - Phone:916-813-7879
Mailing Address - Fax:916-929-9491
Practice Address - Street 1:2277 FAIR OAKS BLVD
Practice Address - Street 2:SUITE 190A
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-5533
Practice Address - Country:US
Practice Address - Phone:916-813-7879
Practice Address - Fax:916-929-9491
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000008462OtherMEDICAL PROVIDER NUMBER