Provider Demographics
NPI:1821073222
Name:HUNTINGTON, KEVIN GARY (MSW)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:GARY
Last Name:HUNTINGTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 STOCKTON BLVD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1451
Mailing Address - Country:US
Mailing Address - Phone:916-734-5595
Mailing Address - Fax:916-734-6652
Practice Address - Street 1:3300 STOCKTON BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1451
Practice Address - Country:US
Practice Address - Phone:916-734-5595
Practice Address - Fax:916-734-6652
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2022-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW159441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical