Healthcare Provider Details

I. General information

NPI: 1447327754
Provider Name (Legal Business Name): ANDRES KERNS PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7090 N ORACLE RD SUITE 178-175
TUCSON AZ
85704-4333
US

IV. Provider business mailing address

7090 N ORACLE RD SUITE 178-175
TUCSON AZ
85704-4333
US

V. Phone/Fax

Practice location:
  • Phone: 520-241-2672
  • Fax: 520-844-9777
Mailing address:
  • Phone: 520-241-2672
  • Fax: 520-844-9777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number3010
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: