Kenneth Alan Logan in Roseville - Clinical
Kenneth Alan Logan - NPI 1003013491
Kenneth Alan Logan is a Clinical in Roseville, California. Kenneth Alan Logan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth Alan Logan is 1003013491. The last update date is 2007-07-08.
Kenneth Alan Logan's current location address is 1891 E Roseville Pkwy, Roseville, California. You can contact this provider via phone number 9167897082 and fax number 9167978840. The mailing address for Kenneth Alan Logan is 1891 E Roseville Pkwy, Roseville, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Alan Logan |
|---|---|
| Address | 1891 E Roseville Pkwy, Roseville, California |
| Phone Number | 9167897082 |
| Fax Number | 9167978840 |
| Sole Proprietor | Y |
| Credentials | PSY.D. |
NPI Number Detail
| NPI Number | 1003013491 |
|---|---|
| Provider Enumeration Date | 2007-06-28 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1891 E Roseville Pkwy |
|---|---|
| City | Roseville |
| State | California (CA) |
| Post Code | 956617973 |
| Phone Number | 9167897082 |
| Fax Number | 9167978840 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 103Tc0700X |
| Licence No | PSY21249 |
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Definition: A psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in |
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What is the unique 10-digit identification code issued to Kenneth Alan Logan by the Centers for Medicare & Medicaid Services?
The Kenneth Alan Logan has been assigned the NPI (National Provider Identifier) 1003013491 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Can you provide the Kenneth Alan Logan's physical address?
The Kenneth Alan Logan is physically located at 1891 E Roseville Pkwy, in the city of Roseville, CA, with the postal code 956617973.
What is Kenneth Alan Logan's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Kenneth Alan Logan is Clinical, and the taxonomy code that classifies this field of practice is 103Tc0700X.
On what date did Kenneth Alan Logan receive its 1003013491 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Alan Logan was assigned its 1003013491 on 2007-06-28, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the information related to Kenneth Alan Logan most recently updated or refreshed?
The details pertaining to the Kenneth Alan Logan, including its address, specialty, and other relevant information, were last updated or refreshed on 2007-07-08.