Individual
KEVIN DALE BURCHBY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
8950 VILLA LA JOLLA DR STE B204, LA JOLLA, CA 92037-1705
(858) 215-2675
Mailing address
PO BOX 910646, SAN DIEGO, CA 92191-0646
(858) 692-3685
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
103T00000X
Psychologist
Primary
31247
CA
Other
Enumeration date
05/15/2018
Last updated
10/14/2019
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