Provider Demographics
NPI:1912052929
Name:BUHR, KENNETH S (PHD)
Entity type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:S
Last Name:BUHR
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16314 SUMMER SAGE RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-1438
Mailing Address - Country:US
Mailing Address - Phone:858-663-4907
Mailing Address - Fax:858-487-8743
Practice Address - Street 1:16314 SUMMER SAGE RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-1438
Practice Address - Country:US
Practice Address - Phone:858-663-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2021-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 005552106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist