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NPI Code Detail

MEDICARE: CHRISTINA SAVALAS KOUSAKIS MFT

MEDICARE:   CHRISTINA SAVALAS KOUSAKIS  MFT
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
1103TC0700XClinical PsychologistMFC 48942CA

General Provider Information

NPI Number : 1902228315
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA SAVALAS KOUSAKIS MFT
Provider Business Mailing Address
First Line : 11340 W OLYMPIC BLVD STE 210
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1612
Country : US
Telephone Number : 310-736-5665
Fax Number :
Provider Business Practice Location Address
First Line : 11340 W OLYMPIC BLVD STE 210
Second Line :
City : LOS ANGELES
State : CA
Zip : 90064-1612
Country : US
Telephone Number : 310-736-5665
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2014
Last Update Date : 01/20/2014

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Directions to “ CHRISTINA SAVALAS KOUSAKIS MFT” Practice Location

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