Provider Demographics
NPI:1861260747
Name:KANE, STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9140 ARBOL DEL ROSAL WAY
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-6040
Mailing Address - Country:US
Mailing Address - Phone:805-235-1296
Mailing Address - Fax:
Practice Address - Street 1:9140 ARBOL DEL ROSAL WAY
Practice Address - Street 2:
Practice Address - City:ATASCADERO
Practice Address - State:CA
Practice Address - Zip Code:93422-6040
Practice Address - Country:US
Practice Address - Phone:805-235-1296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18969103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical