DR. PHILIP RICHARD KAVANAUGH (NPI# 1649253204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649253204 |
| Entity Type | Individual |
| Full Name | DR. PHILIP RICHARD KAVANAUGH |
| Credential | M.D. |
| Practice Address |
2542 S Bascom Ave Suite 207 Campbell CA 95008-5526 |
| Mailing Address |
200 Charter Oaks Cir Los Gatos CA 95032-1807 |
| Practice Telephone | 4085593403 |
| Mailing Telephone | 4083706394 |
| Enumeration Date | 2005-11-28 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
C22375 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
2542 S BASCOM AVE SUITE 207 |
| City | CAMPBELL |
| State | CA |
| Zip Code | 95008-5526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740639301 | Carolain Suzuki Peregrino | Nurse Practitioner | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2016-06-05 |
| 1588083992 | Wk Medical Group | Psychiatry & Neurology | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2014-04-14 |
| 1659713329 | Jeweleeh Hanh Yu | Physician Assistant | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2013-07-23 |
| 1124141031 | David Frederick Dahl | Clinical Neuropsychologist | 2542 S Bascom Ave, Ste 265, Campbell, CA 95008-5565 | 2007-04-06 |
| 1073645701 | Archana Narayan Kulkarni | Social Worker | 2542 S Bascom Ave, Suite 255, Campbell, CA 95008-5526 | 2007-03-09 |
| 1871620542 | Sally Ann Sharrock | Marriage & Family Therapist | 2542 S Bascom Ave, 255, Campbell, CA 95008-5526 | 2007-02-28 |
| 1629104617 | Bruce Melvin Wermuth | Psychiatry & Neurology | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2007-02-26 |
| 1194766113 | Maria Virginia Castelli | Registered Nurse | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5541 | 2006-06-09 |
| 1063478964 | Diann Garcia | Nurse Practitioner | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2006-04-21 |
| 1902866049 | George D Guido IIi | Physician Assistant | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5541 | 2006-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780298380 | Kerry Lynn Osteen | Massage Therapist | 3579 S Bascom Ave, Apt 5, Campbell, CA 95008 | 2020-09-02 |
| 1164057550 | Francesca Dalangin | Physical Therapist | 163 E. Hamilton Avenue, Campbell, CA 95008 | 2020-03-06 |
| 1144790767 | Haley Brucato | Behavior Technician | 131 Rose Court Apt. 21, Campbell, CA 95008 | 2018-11-27 |
| 1740765809 | Crystal-xuanthao Nguyen Curammeng | Licensed Vocational Nurse | 251 Llwelyn Ave, Campbell, CA 95008 | 2018-09-25 |
| 1841799236 | Gabrielle Suzanne Buma | Physician Assistant | Uplift Family Services 251 Llewellyn Ave, Campbell, CA 95008 | 2018-02-12 |
| 1093214660 | Toni Lynn Clementi | Marriage & Family Therapist | 116 E. Campbell Ave, Campbell, CA 95008 | 2018-02-08 |
| 1184132573 | My Hanh Thi Nguyen | Behavioral Analyst | 1440 Theresa Avenue, Campbell, CA 95008 | 2018-01-19 |
| 1346770948 | Stephanie Michele Klahold | Pharmacist | 100 North San Tomas Aquino Road, Campbell, CA 95008 | 2017-06-15 |
| 1578095378 | Elina Josephson | Marriage & Family Therapist | 155 E Campbell Ave Ste 117, Campbell, CA 95008 | 2017-03-30 |
| 1912448408 | Suzane Mitchualmacauley | Licensed Vocational Nurse | 251 Llewelyn Ave, Uplift Family Services, Campbell, CA 95008 | 2017-03-16 |
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| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043705908 | Verdant Behavioral Health, A Nursing Organization | Psychiatry & Neurology | 125 E Campbell Ave # 201, Campbell, CA 95008-7700 | 2018-06-24 |
| 1760898100 | Rebecca A. Powers | Psychiatry & Neurology | 51 E. Campbell Ave. Ste. 170, Campbell, CA 95008 | 2014-07-07 |
| 1548402019 | Jeffrey Chen | Psychiatry & Neurology | 51 E Campbell Ave Ste 170, Campbell, CA 95008-2001 | 2009-03-30 |
| 1811193477 | Naima Siddiqui | Psychiatry & Neurology | 200 E Hacienda Avenue, Permanente Medical Group Campbell Medical Offices, Campbell, CA 95008 | 2007-06-21 |
| 1649305905 | M. Douglas Mar | Psychiatry & Neurology | 3425 S Bascom Ave Ste 250, Campbell, CA 95008-7321 | 2007-02-23 |
| 1356480362 | Anthony E. Atwell | Psychiatry & Neurology | 51 E. Campbell Ave., Suite 170, Campbell, CA 95008 | 2007-02-06 |
| 1588083992 | Wk Medical Group | Psychiatry & Neurology | 2542 S Bascom Ave, Ste 110, Campbell, CA 95008-5526 | 2014-04-14 |
| 1225455488 | Bob Han | Psychiatry & Neurology | 200 E Hacienda Ave, Campbell, CA 95008 | 2014-03-26 |
| 1013271600 | Rajan Gosain | Psychiatry & Neurology | 2542 S Bascom Ave Ste 110, Campbell, CA 95008-5541 | 2012-06-27 |
| 1205080520 | Jennifer Ann Lancaster | Psychiatry & Neurology | 200 E Hacienda Ave, Kaiser Psychiatry Department, Campbell, CA 95008-6617 | 2008-11-13 |
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| 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.