Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | OS13424 | FL |
N | 207Q00000X | Family Doctor | OT014535 | PA |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 20A14705 | CA |
NPI | 1801150800 |
---|---|
Provider Name | Janet J Kinkead |
First Address | Pasadena, CA 91188-0001 |
Second Address | Pasadena, CA 91188-1615 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2012 |
Last Update Date | 07/12/2021 |