Healthcare Provider Details

I. General information

NPI: 1568994101
Provider Name (Legal Business Name): TAYLOR KUHN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2017
Last Update Date: 07/23/2024
Certification Date: 07/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MIDVALE AVE APT 401
LOS ANGELES CA
90024-5498
US

IV. Provider business mailing address

1400 MIDVALE AVE APT 401
LOS ANGELES CA
90024-5498
US

V. Phone/Fax

Practice location:
  • Phone: 321-698-1832
  • Fax:
Mailing address:
  • Phone: 321-698-1832
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPSY28970
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY28970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: