Healthcare Provider Details

I. General information

NPI: 1225302755
Provider Name (Legal Business Name): JOSEPH NAYLOR KENAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2012
Last Update Date: 02/07/2026
Certification Date: 02/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9735 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-2102
US

IV. Provider business mailing address

9735 WILSHIRE BLVD STE 212
BEVERLY HILLS CA
90212-2102
US

V. Phone/Fax

Practice location:
  • Phone: 415-696-1090
  • Fax:
Mailing address:
  • Phone: 415-696-1090
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA066080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: