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DR. KEITH J ANDERSEN PH.D.

Cognitive & Behavioral >> Psychologist >> Behavioral Health & Social Service Providers

Registrant NPI Number: 1275558694

Individual Registrant:
DR. KEITH J ANDERSEN PH.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
152 PIONEER LN STE H  BISHOP, CA 93514-2563 US
Tel: 760-873-6712  Fax: 760-873-6712

Contact information for business:
PO BOX 873  BISHOP, CA 93515-0873 US
Tel: 760-873-6712  Fax: 760-873-6712

Registration Information:
NPI: 1275558694
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103TB0200XBehavioral Health & Social Service Providers
Psychologist
Cognitive & Behavioral
CA14114

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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