Provider Demographics
NPI:1942850730
Name:KUHLOW, KEVIN (LAADC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:KUHLOW
Suffix:
Gender:M
Credentials:LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7052 SANTA TERESA BLVD STE 1044
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95139-1348
Mailing Address - Country:US
Mailing Address - Phone:855-478-4357
Mailing Address - Fax:541-897-8298
Practice Address - Street 1:122 LAWNVIEW CIR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526-5108
Practice Address - Country:US
Practice Address - Phone:650-290-2280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-13
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
CALR10010621101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty