Individual
DR. KEVIN JAY AXELRAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1137 2ND ST, SUITE 207, SANTA MONICA, CA 90403-5011
(310) 393-2186
(805) 523-7426
Mailing address
4188 SANDY HOLLOW CT, MOORPARK, CA 93021-3328
(805) 529-3506
(805) 523-7426
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY 7943
CA
Other
Enumeration date
11/09/2006
Last updated
07/08/2007
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