Healthcare Provider Details

I. General information

NPI: 1891041760
Provider Name (Legal Business Name): MOLLY KIEREIN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MOLLY KIEREIN PSYD

II. Dates (important events)

Enumeration Date: 07/30/2012
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6220 W 3RD ST APT 116
LOS ANGELES CA
90036-3169
US

IV. Provider business mailing address

6220 W 3RD ST APT 116
LOS ANGELES CA
90036-3169
US

V. Phone/Fax

Practice location:
  • Phone: 415-723-1875
  • Fax:
Mailing address:
  • Phone: 415-723-1875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY29895
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: