DR. KEVIN KUKOLECK (NPI# 1295821171) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295821171 |
| Entity Type | Individual |
| Full Name | DR. KEVIN KUKOLECK |
| Credential | PSYD |
| Practice Address |
464 Prestige Ln Rancho Cordova CA 95670-4317 |
| Practice Telephone | 7735735393 |
| Mailing Telephone | 7735735393 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2019-08-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
29905 | CA | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
71006575 | IL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3166 N Lincoln Ave Ste 325, Chicago, IL 606573174 | 7734053541 |
| Street Address |
464 PRESTIGE LN |
| City | RANCHO CORDOVA |
| State | CA |
| Zip Code | 95670-4317 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689297640 | Blue Angels Trans LLC | Non-emergency Medical Transport (VAN) | 11082 Coloma Rd. Suite #10, Rancho Cordova, CA 95670 | 2020-05-26 |
| 1104452796 | Stephanie Lynn Miller | Registered Nurse | 10850 Golden Center Drive, Rancho Cordova, CA 95670 | 2020-03-16 |
| 1174165948 | Sacramento County Office of Education | Clinic/Center | Mitchell Middle School/folsom-cordova Unified School Di, 2100 Zinfandel Drive, School Counseling Office, Rancho Cordova, CA 95670 | 2019-10-14 |
| 1700364353 | Kavneet Bindra | Dentist | 3191 Zinfandel Dr Ste 21, Rancho Cordova, CA 95670 | 2018-08-04 |
| 1487172029 | Monica Jackson | Registered Nurse | 3235 Gosport Way, Rancho Cordova, CA 95670 | 2017-09-05 |
| 1710408422 | Noemi Colmenares | Specialist/Technologist | 11100 Coloma Rd., Rancho Cordova, CA 95670 | 2017-07-03 |
| 1245779552 | Kristin Lyn Kaminski-wadle | Student in an Organized Health Care Education/Training Program | 11344 Coloma Rd Ste 515, Gold River, CA 95670 | 2017-02-20 |
| 1801331822 | Margrette Elaine Townsend | Counselor | 2379 Stone River Ct, Gold River, CA 95670 | 2016-12-29 |
| 1164889572 | Jose H Macaspac Iv | Physical Therapist | 12155 Tributary Point Dr Apt 124, Rancho Cordova, CA 95670 | 2016-01-15 |
| 1972971620 | Harry James Buzbuzian Jr. | General Practice | 11345 Gold Country Blvd, Gold River, CA 95670 | 2015-09-11 |
| Find all providers in zip 95670 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558584334 | Virginia H. Enrico | Psychologist | 11137 Nile River Ct, Suite 100, Rancho Cordova, CA 95670-2941 | 2007-04-10 |
| 1730337775 | Vanessa Cruz Fontes | Psychologist | 10725 International Dr, Rancho Cordova, CA 95670-7967 | 2008-09-03 |
| 1447463088 | Andrea Francisco | Psychologist | 10725 International Dr, Rancho Cordova, CA 95670-7967 | 2007-05-08 |
| 1720101330 | Benjamin Price | Psychologist | 10725 International Dr, Rancho Cordova, CA 95670-7967 | 2007-04-09 |
| 1245397769 | Philip N. Clar | Psychologist | 10725 International Dr, Rancho Cordova, CA 95670-7967 | 2007-01-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164023867 | Watson, Sanchez, & Navarro Psychological Group | Psychologist | 270 E 7th St Ste 1c, Upland, CA 91786-6602 | 2020-11-08 |
| 1558962324 | Marjan-marcia Khalitchi-alavi | Psychologist | 12400 Wilshire Blvd #230, Los Angeles, CA 90025 | 2020-11-06 |
| 1982203568 | Gautami Polepally Ashok | Psychologist | 1234 W Chapman Ave Ste 203, Orange, CA 92868-2863 | 2020-10-23 |
| 1851990626 | Sarah R Martin | Psychologist | 650 Charles E Young Dr S # 12-096, Los Angeles, CA 90095-8347 | 2020-10-22 |
| 1184223851 | Emily Jenchura | Psychologist | 11301 Wilshire Blvd (116b, Rm. A-130), Los Angeles, CA 90073 | 2020-10-22 |
| 1588261580 | Pamela J Newman | Psychologist | 3737 Elderberry Gln, Escondido, CA 92025-7910 | 2020-10-04 |
| 1689271785 | Michelle Sullivan | Psychologist | 2419 44th Ave, San Francisco, CA 94116-2062 | 2020-10-02 |
| 1184231730 | Joanna Lesley Kaye | Psychologist | 3555 Rosecrans St Ste 114-212, San Diego, CA 92110-3231 | 2020-09-28 |
| 1174130181 | Pamela F. Benyas | Psychologist | Dr. Pamela Benyas, 4419 Vans Nuys Bl #400, Sherman Oaks, CA 91403 | 2020-09-24 |
| 1730795634 | Maya Boustani | Psychologist | 5441 Dundee Ct, Rancho Cucamonga, CA 91739-2604 | 2020-09-17 |
| Find all providers with the same taxonomy | ||||
| City | RANCHO CORDOVA |
| Zip Code | 95670 |
Please comment or provide details below to improve the information on DR. KEVIN KUKOLECK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.