Organization
KGN PSYCHOLOGICAL SERVICES, INC.
Active
Other names
Kelly Granger Nguyen, Psy.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY MARIE GRANGER PSY.D. (PRESIDENT/SECRETARY)
(949) 381-1519
Entity
Organization
Contact information
Practice address
222 W MAIN ST, #101, TUSTIN, CA 92780-7720
(949) 381-1519
Mailing address
222 W MAIN ST, #101, TUSTIN, CA 92780-7720
(949) 381-1519
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
28523
CA
Other
Enumeration date
09/10/2016
Last updated
09/10/2016
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