Healthcare Provider Details

I. General information

NPI: 1790660231
Provider Name (Legal Business Name): SASHA MATSUSAKA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2025
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23361 MADERO STE 247
MISSION VIEJO CA
92691-2715
US

IV. Provider business mailing address

1755 SHERINGTON PL APT W310
NEWPORT BEACH CA
92663-6072
US

V. Phone/Fax

Practice location:
  • Phone: 949-357-7066
  • Fax:
Mailing address:
  • Phone: 661-965-5652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: