Healthcare Provider Details

I. General information

NPI: 1396336376
Provider Name (Legal Business Name): HAIDEE CUASIM LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2021
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9425 PENFIELD AVE STE 2700
CHATSWORTH CA
91311-6516
US

IV. Provider business mailing address

9425 PENFIELD AVE STE 2700
CHATSWORTH CA
91311-6516
US

V. Phone/Fax

Practice location:
  • Phone: 828-576-8656
  • Fax:
Mailing address:
  • Phone: 828-576-8656
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number29783
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: