Organization
EL CAMINO PSYCHOLOGY SERVICES. PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BROCK KENNETH KILBOURNE PH.D. (DIRECTOR)
(760) 722-4233
Entity
Organization
Contact information
Practice address
2181 S EL CAMINO REAL STE 307, OCEANSIDE, CA 92054-6288
(760) 722-4233
(760) 722-4232
Mailing address
2181 S EL CAMINO REAL STE 307, OCEANSIDE, CA 92054-6288
(760) 722-4233
(760) 722-4232
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY10467
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PSY10467
—
CA
Enumeration date
03/16/2007
Last updated
10/20/2008
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