Provider Demographics
NPI:1386066041
Name:KIM AJLOUNY, PSY.D.
Entity type:Organization
Organization Name:KIM AJLOUNY, PSY.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KIM
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:AJLOUNY
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:858-229-6986
Mailing Address - Street 1:2351 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:CARDIFF BY THE SEA
Mailing Address - State:CA
Mailing Address - Zip Code:92007-2009
Mailing Address - Country:US
Mailing Address - Phone:858-229-6986
Mailing Address - Fax:858-712-3881
Practice Address - Street 1:5850 OBERLIN DR
Practice Address - Street 2:SUITE 330
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-4719
Practice Address - Country:US
Practice Address - Phone:858-229-6986
Practice Address - Fax:858-712-3881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-15
Last Update Date:2014-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23171103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW416Medicare PIN