Kennedy, Clive Dale

Kennedy, Clive Dale is an sole proprietor health care provider with primary practice located at 1672 W Avenue J Ste 207 , Lancaster CA 93534-2861. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Forensic. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Kennedy, Clive Dale can be contacted via phone (661) 943-3871.

Contact Information

Primary practice address
1672 W Avenue J Ste 207 Lancaster CA 93534-2861
Phone: (661) 943-3871
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 8011 California
Behavioral Health & Social Service Providers / Forensic 103TF0200X PSY 8011 California

Profile Details

NPI number 1841329232
LBN Legal business name Kennedy, Clive Dale
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 3rd, 2007
Last updated Jul 8th, 2007 - about 17 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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