MEDICARE: DR. JOSEPH MICHAEL CASCIANI PHD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	PSY5291	CA

General Provider Information

NPI Number	:	1316975717
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH MICHAEL CASCIANI PHD

Provider Business Mailing Address
First Line	:	4901 MORENA BLVD
Second Line	:	STE 109
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3423
Country	:	US
Telephone Number	:	858-272-3992
Fax Number	:	858-272-3804

Provider Business Practice Location Address
First Line	:	4901 MORENA BLVD
Second Line	:	STE 109
City	:	SAN DIEGO
State	:	CA
Zip	:	92117-3423
Country	:	US
Telephone Number	:	858-272-3992
Fax Number	:	858-272-3804

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	06/23/2008

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