| Kim Ajlouny, Psy.d. | |
|
265 Santa Helena Ste 214 Solana Beach CA 92075 | |
| (858) 480-1661 | |
| (858) 712-3881 |
| Full Name | Kim Ajlouny, Psy.d. |
|---|---|
| Speciality | Psychologist |
| Location | 265 Santa Helena Ste 214, Solana Beach, California |
| Authorized Official Name and Position | Kim Ajlouny Ford (CIINICAL PSYCHOLOGIST/OWNER) |
| Authorized Official Contact | 8582296986 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kim Ajlouny, Psy.d. 2351 Manchester Ave Cardiff CA 92007-2009 Ph: (858) 229-6986 | Kim Ajlouny, Psy.d. 265 Santa Helena Ste 214 Solana Beach CA 92075 Ph: (858) 480-1661 |
| NPI Number | 1568849214 |
|---|---|
| Provider Enumeration Date | 05/01/2015 |
| Last Update Date | 05/16/2018 |
| Medicare PECOS PAC ID | 7719298025 |
|---|---|
| Medicare Enrollment ID | O20150612000529 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568849214 | NPI | - | NPPES |
| CB234246 | Other | CA | MEDICARE PTAN |
| CW586A | Other | CA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | PSY23171 (California) | Primary |
| Provider Name | Kim Ajlouny Ford |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1861721672 PECOS PAC ID: 3072648575 Enrollment ID: I20150612000632 |
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