Dr. Kevin Michael Pernicano, PhD
Psychologist, Clinical in San Antonio, TX. Individual provider (NPI-1).
NPI number1083663835
StatusActive
Last updated in NPPESMar 16, 2020
Details
- NPI
- 1083663835
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kevin Michael Pernicano
- Credential
- PhD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- May 9, 2006
- Certification date
- Mar 16, 2020
- Last updated
- Mar 16, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 37643 | TX | Yes |
Practice location
8800 Village DriveSte 209
San Antonio, TX 78217
Phone 210-202-0100 · Fax 210-579-9705
Mailing address
2071 Wind Chime WayNew Braunfels, TX 78130
Phone 210-278-4584
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