Provider Demographics
NPI:1316328982
Name:NIGHOHOSSIAN, KYLA (MD)
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:NIGHOHOSSIAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6366 SUNNYMERE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-2266
Mailing Address - Country:US
Mailing Address - Phone:618-334-6585
Mailing Address - Fax:
Practice Address - Street 1:6366 SUNNYMERE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-2266
Practice Address - Country:US
Practice Address - Phone:618-334-6585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1250671612084P0800X
CAA1745262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry