Search › California › 101Y00000X
Kevin Killacky
NPI 1003771338 · on the registry since 2025
Practice
- Address
- 2120 San Diego Ave
San Diego, CA 92110 - Phone
- (619) 574-6225
- Organisation at this address
- Old Town Academy
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 17
Registry record
- Primary taxonomy
- 101Y00000X
101Y00000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2025-12-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California