Kenneth John De Haan in San Pedro - Clinical
Kenneth John De Haan - NPI 1174643753
Kenneth John De Haan is a Clinical in San Pedro, California. Kenneth John De Haan practices all healthcare services and medical treatments related to Clinical. The NPI Number for Kenneth John De Haan is 1174643753. The last update date is 2013-06-11.
Kenneth John De Haan's current location address is 704 W 8th St, San Pedro, California. You can contact this provider via phone number 3108327545 and fax number 3108338580. The mailing address for Kenneth John De Haan is 704 W 8th St, San Pedro, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth John De Haan |
|---|---|
| Address | 704 W 8th St, San Pedro, California |
| Phone Number | 3108327545 |
| Fax Number | 3108338580 |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1174643753 |
|---|---|
| Provider Enumeration Date | 2007-03-29 |
| Last Updated Date | 2013-06-11 |
Provider Mailing Address Detail
| Address | 704 W 8th St |
|---|---|
| City | San Pedro |
| State | California (CA) |
| Post Code | 907313017 |
| Phone Number | 3108327545 |
| Fax Number | 3108338580 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCS13281 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Kenneth John De Haan by the Centers for Medicare & Medicaid Services?
The Kenneth John De Haan has been issued the NPI (National Provider Identifier) 1174643753 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Kenneth John De Haan is located?
The Kenneth John De Haan is situated at the following address: 704 W 8Th St, San Pedro, CA, 907313017.
What is Kenneth John De Haan's specialized field of practice, and what is the corresponding taxonomy classification code?
The Kenneth John De Haan's area of specialization is Clinical, and the corresponding taxonomy code that categorizes this field of practice is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1174643753 to Kenneth John De Haan?
The Centers for Medicare & Medicaid Services originally issued the 1174643753 to Kenneth John De Haan on 2007-03-29.
When was the Kenneth John De Haan's information last updated?
The Kenneth John De Haan's information was last updated on 2013-06-11.
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