Provider Demographics
NPI:1891710877
Name:UNKEL, KATHRYN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:S
Last Name:UNKEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2787 RODMAN DR
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS
Mailing Address - State:CA
Mailing Address - Zip Code:93402-4323
Mailing Address - Country:US
Mailing Address - Phone:805-534-1704
Mailing Address - Fax:
Practice Address - Street 1:2280 SUNSET DR
Practice Address - Street 2:STE E
Practice Address - City:LOS OSOS
Practice Address - State:CA
Practice Address - Zip Code:93402-4007
Practice Address - Country:US
Practice Address - Phone:805-528-3395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA746672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry