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Individual

MR. KEVIN JERVIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
411 N HARBOR BLVD, SUITE 300, SAN PEDRO, CA 90731-2200
(310) 833-3696
(310) 833-3572
Mailing address
411 N HARBOR BLVD, SUITE 300, SAN PEDRO, CA 90731-2200
(310) 833-3696
(310) 833-3572

Taxonomy

Speciality
Code
Description
License number
State
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
PSY 19560
CA

Other

Enumeration date
03/26/2007
Last updated
07/08/2007
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