Dr Kenneth Allen Deherrera, PHD - Psychologist in Wateretown, NY

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Dr Kenneth Allen Deherrera, PHD is a Psychologist based in Wateretown, New York. Dr Kenneth Allen Deherrera is licensed to practice in Utah (license number 263423-2501) and his current practice location is Department Of The Army, U.s. Army Medical Department, Activity, Fort Drum, New York, Wateretown, New York. He can be reached at his office (for appointments etc.) via phone at (315) 772-3314.

NPI number for Dr Kenneth Allen Deherrera is 1255386769 and his current mailing address is 410 Holcomb St, Watertown, New York. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1255386769.

Contact Information

Dr Kenneth Allen Deherrera, PHD
Department Of The Army, U.s. Army Medical Department, Activity, Fort Drum, New York,
Wateretown, NY 13602-5004
(315) 772-3314
Not Available

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Healthcare Provider's Profile

Full NameDr Kenneth Allen Deherrera
GenderMale
SpecialityPsychologist
LocationDepartment Of The Army, U.s. Army Medical Department, Wateretown, New York
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1255386769
  • Provider Enumeration Date: 05/23/2006
  • Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Dr Kenneth Allen Deherrera such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255386769NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist 263423-2501 (Utah)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth Allen Deherrera is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Kenneth Allen Deherrera, PHD
410 Holcomb St,
Watertown, NY 13601-3907

Ph: (801) 450-4414		Dr Kenneth Allen Deherrera, PHD
Department Of The Army, U.s. Army Medical Department, Activity, Fort Drum, New York,
Wateretown, NY 13602-5004

Ph: (315) 772-3314

Reviews and Comments


Psychologist in Wateretown, NY


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