Waggoner, Kelly Condon

Waggoner, Kelly Condon is an sole proprietor health care provider with primary practice located at 2200 Pacific Coast Hwy Ste 215 , Hermosa Beach CA 90254-2701. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Waggoner, Kelly Condon can be contacted via phone (310) 567-0456.

Contact Information

Primary practice address
2200 Pacific Coast Hwy Ste 215 Hermosa Beach CA 90254-2701
Phone: (310) 567-0456
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY 24570 California

Profile Details

NPI number 1275867418
LBN Legal business name Waggoner, Kelly Condon
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2009
Last updated Sep 29th, 2011 - about 14 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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