Provider Demographics
NPI:1124561444
Name:KUHN, ROGER J (PHD)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:J
Last Name:KUHN
Suffix:
Gender:
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17589 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:GUERNEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95446-8801
Mailing Address - Country:US
Mailing Address - Phone:415-347-5454
Mailing Address - Fax:
Practice Address - Street 1:17589 SUMMIT AVE
Practice Address - Street 2:
Practice Address - City:GUERNEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95446-8801
Practice Address - Country:US
Practice Address - Phone:415-347-5454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-19
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA96853106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist