Healthcare Provider Details

I. General information

NPI: 1528884160
Provider Name (Legal Business Name): LA PSYCHOLOGY GUIDES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2024
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

419 S EUCALYPTUS AVE # B
INGLEWOOD CA
90301-2605
US

IV. Provider business mailing address

112 S MARKET ST # 112
INGLEWOOD CA
90301-1712
US

V. Phone/Fax

Practice location:
  • Phone: 818-253-9441
  • Fax:
Mailing address:
  • Phone: 818-253-9441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TB0200X
TaxonomyCognitive & Behavioral Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. KEHIANTE MCKINLEY
Title or Position: CEO
Credential: PSYD
Phone: 818-253-9441