Healthcare Provider Details

I. General information

NPI: 1154862357
Provider Name (Legal Business Name): TROY LEWIS KURZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2017
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

462 STEVENS AVE STE 206B
SOLANA BEACH CA
92075-2065
US

IV. Provider business mailing address

462 STEVENS AVE STE 206
SOLANA BEACH CA
92075-2065
US

V. Phone/Fax

Practice location:
  • Phone: 858-617-0004
  • Fax:
Mailing address:
  • Phone: 858-617-0004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA157190
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD209454
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberA157190
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: