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NPI Code Detail

MEDICARE: MICHAEL KITLOWSKI PHD

MEDICARE: MICHAEL KITLOWSKI PHD
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
1103K00000XBehavior Analyst1-09-6512
2103T00000XPsychologistPSY14458CA

General Provider Information

NPI Number : 1679834667
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL KITLOWSKI PHD
Provider Business Mailing Address
First Line : 27268 VIA INDUSTRIA
Second Line :
City : TEMECULA
State : CA
Zip : 92590-3751
Country : US
Telephone Number : 951-265-6504
Fax Number :
Provider Business Practice Location Address
First Line : 27268 VIA INDUSTRIA
Second Line :
City : TEMECULA
State : CA
Zip : 92590-3751
Country : US
Telephone Number : 951-265-6504
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2012
Last Update Date : 06/06/2012

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