Healthcare Provider Details

I. General information

NPI: 1780829713
Provider Name (Legal Business Name): CARI M. KAESLIN PSYD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CARI M BOONE PSYD

II. Dates (important events)

Enumeration Date: 12/04/2008
Last Update Date: 12/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 SKYPARK DR SUITE 220
TORRANCE CA
90505-5023
US

IV. Provider business mailing address

3333 SKYPARK DR SUITE 220
TORRANCE CA
90505-5023
US

V. Phone/Fax

Practice location:
  • Phone: 310-257-5751
  • Fax: 310-257-5753
Mailing address:
  • Phone: 310-257-5751
  • Fax: 310-257-5753

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY20271
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: