Healthcare Provider Details

I. General information

NPI: 1437080918
Provider Name (Legal Business Name): KATE KHOUKAZ PSYCHOLOGY CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 FARADAY AVE STE 116
CARLSBAD CA
92008-7208
US

IV. Provider business mailing address

2244 FARADAY AVE STE 116
CARLSBAD CA
92008-7208
US

V. Phone/Fax

Practice location:
  • Phone: 760-462-5663
  • Fax:
Mailing address:
  • Phone: 760-462-5663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State

VIII. Authorized Official

Name: KATHLYN KHOUKAZ
Title or Position: CLINICAL PSYCHOLOGIST
Credential: PSYD
Phone: 760-462-5663