Active NPI
Jeffrey Kahn, PHD
- Clinical Psychologist
- Santa Rosa, CA
National Provider Identifier
1326119173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY6453
- Practice address
- 509 7TH St
Second Floor
Santa Rosa, CA 95401-5265 - Phone
- (707) 546-4349
- Fax
- (707) 528-0137
- NPI assigned
- Nov 13, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY6453 | CA | Primary |
Addresses
Primary practice location
509 7TH St
Second Floor
Santa Rosa, CA 95401-5265
Mailing address
509 7TH St
Second Floor
Santa Rosa, CA 95401-5265
Phone (707) 546-4349
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY6453 | CA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326119173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 7TH ST",
"address_2": "SECOND FLOOR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015265",
"telephone_number": "707-546-4349",
"fax_number": "707-528-0137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 7TH ST",
"address_2": "SECOND FLOOR",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954015265",
"telephone_number": "707-546-4349",
"fax_number": "707-528-0137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAHN",
"first_name": "JEFFREY",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY6453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
- Kendal Kagawa
- Lydia Carlton Turner Kagel, AMFT
- Martha Jane Kahane, PHD.
- Alem Kahassai
- Natasha Ann Kahl, MD
- Zachary Williford Kahn, LMFT
- Etram Mekonnen Kahsay
- Althea Kai, MA, LMFT
- Kaiser Foundation Health Plan Inc (Kaiser Health Plan 2 West Pharmacy 582)
- Kaiser Foundation Health Plan Inc (Kaiser Oncology Pharmacy #586)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.