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NPI Code Detail

MEDICARE: DR. DOUGLAS TAYLOR KASLE PH.D

MEDICARE:  DR. DOUGLAS TAYLOR KASLE  PH.D
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20824CA

General Provider Information

NPI Number : 1962676361
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS TAYLOR KASLE PH.D
Provider Business Mailing Address
First Line : 303 POTRERO ST
Second Line : UNIT 307
City : SANTA CRUZ
State : CA
Zip : 95060-2741
Country : US
Telephone Number : 415-846-6401
Fax Number :
Provider Business Practice Location Address
First Line : 1848 MCALLISTER ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94115-4321
Country : US
Telephone Number : 415-846-6401
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2008
Last Update Date : 02/08/2019

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Directions to “ DR. DOUGLAS TAYLOR KASLE PH.D” Practice Location

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