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General NPI Number Information
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NPI Number | 1548896400
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Entity Type | Individual
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Provider Name | KEVIN PATRICK KENNEDY MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2020
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 3900 WOODLAND AVE RM A2118
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City | PHILADELPHIA
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State | PA
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Zip | 19104-4551
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Country | US
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Telephone | 215-823-5800
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Fax |
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Provider Business Mailing Address
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Address Line | UCLA PSYCHIATRY HOUSE STAFF OFFICE 760 WESTWOOD PLAZA S SUITE 37-384
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City | LOS ANGELES
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State | CA
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Zip | 90024
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Country | US
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Telephone | 310-794-6298
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Fax | 424-377-6712
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD486301
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A179144
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License Number State | CA
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