Provider Demographics
NPI:1811627151
Name:HAUSHEER, KYLE FREDERICK (AMFT)
Entity Type:Individual
Prefix:MR
First Name:KYLE
Middle Name:FREDERICK
Last Name:HAUSHEER
Suffix:
Gender:M
Credentials:AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11172 VISTA SORRENTO PKWY APT 306
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-7616
Mailing Address - Country:US
Mailing Address - Phone:541-990-9753
Mailing Address - Fax:
Practice Address - Street 1:11172 VISTA SORRENTO PKWY APT 306
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-7616
Practice Address - Country:US
Practice Address - Phone:541-990-9753
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA129115106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist