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General NPI Number Information
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NPI Number | 1174548242
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Entity Type | Individual
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Provider Name | DR. KATHY LYNN PARISH
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Gender | Female
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 919 N SUNSET AVE
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City | WEST COVINA
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State | CA
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Zip | 91790-1244
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Country | US
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Telephone | 800-257-8715
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Fax |
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Provider Business Mailing Address
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Address Line | 1609 BUSHNELL AVE
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-4901
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Country | US
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Telephone | 626-441-4861
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY7516
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License Number State | CA
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