Individual
DR. DUSTIN KIESCHNICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
497 TAHOE KEYS BLVD APT 35, SOUTH LAKE TAHOE, CA 96150-3841
(910) 467-3217
Mailing address
497 TAHOE KEYS BLVD APT 35, SOUTH LAKE TAHOE, CA 96150-3841
(910) 467-3217
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32828
CA
Other
Enumeration date
09/13/2021
Last updated
06/09/2026
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