Individual
DR. KEARNEY NICOLE VISSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
12655 W WASHINGTON BLVD STE 208, LOS ANGELES, CA 90066-2395
(310) 409-5463
Mailing address
12655 W WASHINGTON BLVD STE 208, LOS ANGELES, CA 90066-2395
(310) 409-5463
Taxonomy
Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY23855
CA
Other
Enumeration date
11/27/2006
Last updated
03/03/2020
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