Individual
DR. KATHLEEN ANN LONGWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
75 SELBORNE DR, PIEDMONT, CA 94611-3618
(510) 530-7300
(510) 530-6269
Mailing address
75 SELBORNE DR, PIEDMONT, CA 94611-3618
(510) 530-7300
(510) 530-6269
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY13730
CA
103T00000X
Psychologist
PY3473
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5110027
MEDICAL
CA
Enumeration date
07/12/2006
Last updated
07/08/2007
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