Provider Demographics
NPI:1396935698
Name:KAIRYS, CHARLES FRANK (PSYD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:FRANK
Last Name:KAIRYS
Suffix:
Gender:M
Credentials:PSYD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:3625 E THOUSAND OAKS BLVD
Mailing Address - Street 2:STE 209
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3566
Mailing Address - Country:US
Mailing Address - Phone:818-645-3337
Mailing Address - Fax:805-496-1973
Practice Address - Street 1:3625 E THOUSAND OAKS BLVD
Practice Address - Street 2:STE 209
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3566
Practice Address - Country:US
Practice Address - Phone:818-645-3337
Practice Address - Fax:805-496-1973
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24995103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical