Provider Demographics
NPI:1255371472
Name:KANOFSKY, STEVEN E (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:E
Last Name:KANOFSKY
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11740 DUBLIN BLVD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2823
Mailing Address - Country:US
Mailing Address - Phone:925-682-3697
Mailing Address - Fax:925-828-8238
Practice Address - Street 1:11740 DUBLIN BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2823
Practice Address - Country:US
Practice Address - Phone:925-682-3697
Practice Address - Fax:925-828-8238
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY12659103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist