Dr. Kevin Kukoleck, PsyD
Psychologist, Clinical in Travis Afb, CA. Individual provider (NPI-1).
NPI number1295821171
StatusActive
Last updated in NPPESSep 25, 2024
Details
- NPI
- 1295821171
- Entity type
- Individual (NPI-1)
- Name
- Dr. Kevin Kukoleck
- Credential
- PsyD
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 5, 2006
- Certification date
- Sep 25, 2024
- Last updated
- Sep 25, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TC0700X | Psychologist, Clinical | 29905 | CA | Yes |
| 103TC0700X | Psychologist, Clinical | 08214 | OH |
Practice location
101 Bodin CirTravis Afb, CA 94535-1809
Phone 707-423-5174
Mailing address
101 Bodin CirTravis Afb, CA 94535-1809
Phone 707-423-5174
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