Healthcare Provider Details

I. General information

NPI: 1952973828
Provider Name (Legal Business Name): CASEY MACGREGOR-TOSHIMA LCSW PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/12/2021
Last Update Date: 06/07/2024
Certification Date: 06/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 FREMONT AVE UNIT D
SOUTH PASADENA CA
91030-3225
US

IV. Provider business mailing address

494 AVENUE 64
PASADENA CA
91105-2257
US

V. Phone/Fax

Practice location:
  • Phone: 626-657-8543
  • Fax:
Mailing address:
  • Phone: 917-969-3009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State

VIII. Authorized Official

Name: DR. CASEY R MACGREGOR TOSHIMA
Title or Position: OWNER
Credential: PHD LCSW
Phone: 917-969-3009