Individual
DR. CHARLES KODIMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
10927 DOWNEY AVE STE C, DOWNEY, CA 90241-3739
(562) 861-6180
(951) 694-0553
Mailing address
41934 MAIN ST STE 203, TEMECULA, CA 92590-2714
(562) 861-6180
(951) 694-0553
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
PSY 6629
CA
103TC0700X
Clinical Psychologist
Primary
PSY 6629
CA
106H00000X
Marriage & Family Therapist
MFC 6318
CA
Other
Enumeration date
07/07/2006
Last updated
08/25/2015
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