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Individual

KEVIN MCCANN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CTRS, RTC, CCCI

Contact information

Practice address
201 9TH ST # 11-K, MARINA, CA 93933-6039
(831) 884-1000
Mailing address
201 9TH ST # 11-K, MARINA, CA 93933-6039
(831) 884-1000

Taxonomy

Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
4093-T
CA
225800000X
Recreation Therapist
Primary
53896
CA

Other

Enumeration date
06/03/2020
Last updated
06/03/2020
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