Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY 9417 | CA |
Y | 103T00000X | Psychologist | PSY 9417 | CA |
NPI | 1013937333 |
---|---|
Provider Name | Dr. Kaseja Kang |
First Address | Sacramento, CA 95814-6414 |
Second Address | Pomona, CA 91768-3238 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |