Keomahavong, Nick

Keomahavong, Nick is an individual health care provider with primary practice located at 17701 San Pasqual Valley Rd , Escondido CA 92025-5301. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Marriage & Family Therapist is his primary health care specialty. Keomahavong, Nick can be contacted via phone (760) 741-4300.

Contact Information

Primary practice address
17701 San Pasqual Valley Rd Escondido CA 92025-5301
Phone: (760) 741-4300
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X

Profile Details

NPI number 1669605663
LBN Legal business name Keomahavong, Nick
Credentials IMF
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 25th, 2009
Last updated Apr 6th, 2011 - about 13 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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