Provider Demographics
NPI:1831410364
Name:KIRCHEN, CAMALA (PSYD)
Entity type:Individual
Prefix:DR
First Name:CAMALA
Middle Name:
Last Name:KIRCHEN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 COLLEGE AVE
Mailing Address - Street 2:SUITE 220B
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94618-1625
Mailing Address - Country:US
Mailing Address - Phone:510-565-7433
Mailing Address - Fax:
Practice Address - Street 1:5665 COLLEGE AVE
Practice Address - Street 2:SUITE 220B
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94618-1625
Practice Address - Country:US
Practice Address - Phone:510-565-7433
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-18
Last Update Date:2015-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY27188103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical