Organization
ELLEN MILLER KWON, PSYD
Active
Other names
Ellen Marie Kwon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELLEN MARIE KWON PSY,D, (OWNER)
(626) 807-5451
Entity
Organization
Contact information
Practice address
65 N MADISON AVE, SUITE 405, PASADENA, CA 91101-2035
(626) 807-5451
(626) 395-7751
Mailing address
65 N MADISON AVE, SUITE 405, PASADENA, CA 91101-2035
(626) 807-5451
(626) 395-7751
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
24302
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1376741884
INDIVIDUAL NPI
CA
01
—
24302
BOARD OF PSYCHOLOGY
CA
Enumeration date
11/12/2013
Last updated
11/12/2013
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