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NPI Code Detail

MEDICARE: DR. KARI KILLIANEY PSY.D.

MEDICARE: DR. KARI KILLIANEY PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist22479CA

General Provider Information

NPI Number : 1124125364
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KARI KILLIANEY PSY.D.
Provider Business Mailing Address
First Line : 617 VETERANS BLVD STE 204
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1419
Country : US
Telephone Number : 510-798-5513
Fax Number :
Provider Business Practice Location Address
First Line : 617 VETERANS BLVD STE 204
Second Line :
City : REDWOOD CITY
State : CA
Zip : 94063-1419
Country : US
Telephone Number : 510-798-5513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 11/28/2016

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