Provider Demographics
NPI:1851304661
Name:KALEHZAN, B. MICHELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:B. MICHELLE
Middle Name:
Last Name:KALEHZAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 FREMONT AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94024-5698
Mailing Address - Country:US
Mailing Address - Phone:650-941-4444
Mailing Address - Fax:408-733-5578
Practice Address - Street 1:851 FREMONT AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5698
Practice Address - Country:US
Practice Address - Phone:650-941-4444
Practice Address - Fax:408-733-5578
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15676103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical