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Organization

ATTENTION, LEARNING & DEVELOPMENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KAYCIE DEANE PHD (PSYCHOLOGIST/OWNER)
(908) 507-9457
Entity
Organization

Contact information

Practice address
3812 SEPULVEDA BLVD STE 350, TORRANCE, CA 90505-2496
(310) 378-6154
Mailing address
3812 SEPULVEDA BLVD STE 350, TORRANCE, CA 90505-2496
(310) 378-6154

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04561460
PRIVATE PAY ONLY
CA
Enumeration date
05/30/2021
Last updated
05/30/2021
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