Kenneth David Sekulic, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

016339 Issued in NY

Practice address

3075 Corbina Aly
Suite 1
San Diego, CA 92136-5112

Phone

(619) 556-7641

Fax

(619) 556-8413

NPI assigned

May 13, 2013

Last updated

May 13, 2013By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1368403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368403200000",
    "number": "1649616087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9388 BABAUTA RD",
            "address_2": "SUITE 128",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921294932",
            "telephone_number": "619-556-7641",
            "fax_number": "619-556-8413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 CORBINA ALY",
            "address_2": "SUITE 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921365112",
            "telephone_number": "619-556-7641",
            "fax_number": "619-556-8413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEKULIC",
        "first_name": "KENNETH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-13",
        "last_updated": "2013-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "016339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tro Boghos Sekayan, MD
• Jade Lequinn Sekeres, PNP
• Sumie Seki
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• Patricia Yayra Sekre
• Ruth B Selassie
• Caron A. Selati, M.D.
• Annemarie Selaya, M.D.
• Blake Alexis Selby, CPNP
• Mason Selby

• Clinical Psychologist in San Diego, CA
• Providers in San Diego, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.