MEDICARE: JOSEPH KHEDRY ABDELMESSEH LCSW

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	1041C0700X	Clinical Social Worker	LCSW137943	CA

General Provider Information

NPI Number	:	1730661851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH KHEDRY ABDELMESSEH LCSW

Provider Business Mailing Address
First Line	:	125 W THOUSAND OAKS BLVD STE 500
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-4462
Country	:	US
Telephone Number	:	805-777-3500
Fax Number	:

Provider Business Practice Location Address
First Line	:	125 W. THOUSAND OAKS BLVDS., SUITE 500
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360
Country	:	US
Telephone Number	:	805-777-3500
Fax Number	:

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

Provider Enumeration Date	:	09/05/2018
Last Update Date	:	05/14/2026

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