Condon, Kathleen M

Condon, Kathleen M is an individual health care provider with primary practice located at 1080 Emeline Ave , Santa Cruz CA 95060-1966. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Condon, Kathleen M can be contacted via phone (831) 454-4100.

Contact Information

Primary practice address
1080 Emeline Ave Santa Cruz CA 95060-1966
Phone: (831) 454-4100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY-202418 Idaho
Behavioral Health & Social Service Providers / Psychologist 103T00000X 24048 California

Profile Details

NPI number 1053580308
LBN Legal business name Condon, Kathleen M
Credentials PSY.D
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 20th, 2008
Last updated Aug 29th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053580308 NPPES
California Other 24048 PSYCHOLOGIST LICENSE NUMBER
California Other 1659315430 PSYCHOLOGIST LICENSE NUMBER
California MEDICAID FHC70042F PSYCHOLOGIST LICENSE NUMBER

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