Provider Demographics
NPI:1922864032
Name:KMN PSYCHOLOGY INC
Entity Type:Organization
Organization Name:KMN PSYCHOLOGY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MAX
Authorized Official - Middle Name:IAN
Authorized Official - Last Name:DOSHAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-922-4946
Mailing Address - Street 1:3760 CONVOY ST STE 223
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3744
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3760 CONVOY ST STE 223
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-3744
Practice Address - Country:US
Practice Address - Phone:858-922-4946
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)