Kenneth Burton Kaisch, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY10635 Issued in CA

Practice address

2555 E Chapman Ave Ste 617
Fullerton, CA 92831-3621

Phone

(714) 992-4656

NPI assigned

Mar 24, 2007

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1174694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942327705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 E CHAPMAN AVE STE 617",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313621",
            "telephone_number": "714-992-4656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 E CHAPMAN AVE STE 617",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928313621",
            "telephone_number": "714-992-4656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAISCH",
        "first_name": "KENNETH",
        "middle_name": "BURTON",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": "PSY10635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychologist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Psychologist in California

• 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.

Verify at the official NPI Registry.