Provider Demographics
NPI:1881902054
Name:JABLONSKI-KAYE, DENISE M (PHD)
Entity type:Individual
Prefix:DR
First Name:DENISE
Middle Name:M
Last Name:JABLONSKI-KAYE
Suffix:
Gender:F
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:PO BOX 75
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91376-0075
Mailing Address - Country:US
Mailing Address - Phone:805-374-8730
Mailing Address - Fax:
Practice Address - Street 1:2660 TOWNSGATE RD
Practice Address - Street 2:SUITE 530
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91361-2714
Practice Address - Country:US
Practice Address - Phone:805-374-8730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY8545103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical