Kelly Condon Waggoner, PSY.D. Valid NPI

Individual provider · Clinical Psychologist · Hermosa Beach, CA

NPI

1275867418

Type

Individual (Type 1)

Primary specialty

Clinical Psychologist (Psychologist)

Specialty group

Behavioral Health & Social Service Providers

Taxonomy code

103TC0700X

License number

PSY 24570 (CA)

Sex

Female

Sole proprietor

Yes

Enumerated

2009-09-21

Last updated

2011-09-29