Doctor Name: | MS. KAY WICKETT OSTENSEN |
NPI Number: | 1104020189 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | 6951 |
Business Practice Address: | 1278 Glenneyre Psychology Center #d Laguna Beach, CA - 92651 |
Business Phone Number: | 9494945460 |
Business Fax Number: | 9492098777 |
Mailing Address: | 1278 Glenneyre, Suite #22 LAGUNA BEACH |
State: | CA |
Postal Code: | 92651 |
Phone Number: | 9494945460 |
Fax Number: | 9492098777 |
NPI Enumeration Date: | 06/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | 6951 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |