Healthcare Provider Details

I. General information

NPI: 1770877433
Provider Name (Legal Business Name): SALEM KENSIK PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2011
Last Update Date: 05/30/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31625 HIGHWAY 101 S
SOLEDAD CA
93960-9529
US

IV. Provider business mailing address

PO BOX 5842
CARMEL CA
93921-5842
US

V. Phone/Fax

Practice location:
  • Phone: 831-678-5500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY23341
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: