Kerry A. Hannifin, Psy.D., INC.
Psychologist in Colton, CA. Organization (NPI-2).
NPI number1114439890
StatusActive
Last updated in NPPESNov 2, 2017
Details
- NPI
- 1114439890
- Entity type
- Organization (NPI-2)
- Legal business name
- Kerry A. Hannifin, Psy.D., INC.
- Organization subpart
- No
- Enumeration date
- Nov 2, 2017
- Last updated
- Nov 2, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103T00000X | Psychologist | PSY24515 | CA | Yes |
Practice location
1850 E Washington StColton, CA 92324-4621
Phone 844-374-6336
Mailing address
8780 19th St Ste 411Alta Loma, CA 91701-4608
Authorized official
Kerry A Hannifin
Psychologist/President
3107103027
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