Provider Demographics
NPI:1881669190
Name:KERN, DONALD
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:
Last Name:KERN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 NORTHSHORE LN
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-3318
Mailing Address - Country:US
Mailing Address - Phone:818-591-1590
Mailing Address - Fax:805-370-3177
Practice Address - Street 1:23123 VENTURA BLVD
Practice Address - Street 2:STE. 208
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-1104
Practice Address - Country:US
Practice Address - Phone:818-591-1590
Practice Address - Fax:805-370-3177
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-21
Last Update Date:2018-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31348106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist