Provider Demographics
NPI:1477174399
Name:KUHN, KIRSTEN (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:
Last Name:KUHN
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 POLK AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-1709
Mailing Address - Country:US
Mailing Address - Phone:619-846-0639
Mailing Address - Fax:
Practice Address - Street 1:1120 SILVERADO ST STE 203
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-4524
Practice Address - Country:US
Practice Address - Phone:858-412-5141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95014479363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health