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General NPI Number Information
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NPI Number | 1699423764
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Entity Type | Individual
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Provider Name | KEHIANTE MCKINLEY PSYD
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Gender | Female
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Dates
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Enumeration Date | 03/16/2022
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Last Update Date | 11/09/2024
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Provider Practice Location Address
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Address Line | 419 S EUCALYPTUS AVE UNIT B
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City | INGLEWOOD
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State | CA
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Zip | 90301-2605
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Country | US
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Telephone | 818-253-9441
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Fax |
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Provider Business Mailing Address
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Address Line | 112 S MARKET ST # 112
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City | INGLEWOOD
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State | CA
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Zip | 90301-1712
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Country | US
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Telephone | 406-868-5508
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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 | 35488
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 35488
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License Number State | CA
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