Healthcare Provider Details

I. General information

NPI: 1952822611
Provider Name (Legal Business Name): KYLE KAI-WEI CHUANG PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2017
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 BIXLER DR APT 807
LAS CRUCES NM
88012-5111
US

IV. Provider business mailing address

3402 BIXLER DR APT 807
LAS CRUCES NM
88012-5111
US

V. Phone/Fax

Practice location:
  • Phone: 858-200-6895
  • Fax:
Mailing address:
  • Phone: 858-200-6895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY-2025-0115
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY36811
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: