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NPI Lookup from the NPI Registry — National Provider Identifier Database

Contact Information

KENNETH A LOGAN, PSY.D.
1891 E ROSEVILLE PKWY
SUITE 100
ROSEVILLE, CA95661-7973
 Phone: 916-789-7082
 Fax: 916-797-8840
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KENNETH A LOGAN · (Male)

NPI Number 1003013491
Status Active
Credentials PSY.D. (Doctor of Psychology)
Entity Individual
Enumeration date 06/28/2007
Last updated 07/08/2007 - About 12 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # PSY21249
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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