Healthcare Provider Details
I. General information
NPI: 1477275493
Provider Name (Legal Business Name): TELEGRAPH PSYCHOLOGY COLLECTIVE PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/15/2022
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
264 ARLINGTON AVE
KENSINGTON CA
94707-1416
US
IV. Provider business mailing address
264 ARLINGTON AVE
KENSINGTON CA
94707-1416
US
V. Phone/Fax
- Phone: 510-224-5591
- Fax:
- Phone: 415-295-6457
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
DANIELLE
KASSOUF
Title or Position: DIRECTOR
Credential: PSYD
Phone: 415-295-6457