Provider Demographics
NPI:1295930220
Name:HARDING, KEVIN
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:
Last Name:HARDING
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 1:94-615 KAHAKEA ST APT 10F
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-1146
Mailing Address - Country:US
Mailing Address - Phone:415-694-2040
Mailing Address - Fax:415-534-8900
Practice Address - Street 1:94-615 KAHAKEA ST APT 10F
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-1146
Practice Address - Country:US
Practice Address - Phone:415-694-2040
Practice Address - Fax:415-534-8900
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2018-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43089106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist