MEDICARE: MR. DAVID R KAUSS PH.D

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	103TA0700X	Adult Development & Aging Psychologist	PSY5556	CA
2	103TB0200X	Cognitive & Behavioral Psychologist	PSY5556	CA
3	103TC0700X	Clinical Psychologist	PSY 5556	CA
4	103TE1100X	Exercise & Sports Psychologist	PSY 5556	CA
5	103TF0000X	Family Psychologist	PSY 5556	CA
6	103TF0200X	Forensic Psychologist	PSY 5556	CA
7	103TH0100X	Health Service Psychologist	PSY 5556	CA
8	103T00000X	Psychologist	PSY 5556	CA

General Provider Information

NPI Number	:	1912924994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID R KAUSS PH.D

Provider Business Mailing Address
First Line	:	10921 WILSHIRE BLVD
Second Line	:	SUITE 1101
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4005
Country	:	US
Telephone Number	:	310-826-9576
Fax Number	:	310-573-0346

Provider Business Practice Location Address
First Line	:	10921 WILSHIRE BLVD
Second Line	:	SUITE 1101
City	:	LOS ANGELES
State	:	CA
Zip	:	90024-4005
Country	:	US
Telephone Number	:	310-826-9576
Fax Number	:	310-573-0346

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

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	01/18/2017

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Directions to “ MR. DAVID R KAUSS PH.D” Practice Location

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