Provider Demographics
NPI:1154923498
Name:KAHN, BRYN JOHANNA (PSYD)
Entity type:Individual
Prefix:DR
First Name:BRYN
Middle Name:JOHANNA
Last Name:KAHN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 NORWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:94707-1118
Mailing Address - Country:US
Mailing Address - Phone:510-833-7825
Mailing Address - Fax:
Practice Address - Street 1:3 ALTARINDA RD STE 118-222
Practice Address - Street 2:
Practice Address - City:ORINDA
Practice Address - State:CA
Practice Address - Zip Code:94563-2601
Practice Address - Country:US
Practice Address - Phone:510-833-7825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-11
Last Update Date:2020-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28688103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical