Healthcare Provider Details

I. General information

NPI: 1851726145
Provider Name (Legal Business Name): DANIEL KAUSHANSKY PSY.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 11/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23501 CINEMA DR SUITE 210
VALENCIA CA
91355-5428
US

IV. Provider business mailing address

23501 CINEMA DR SUITE 210
VALENCIA CA
91355-5428
US

V. Phone/Fax

Practice location:
  • Phone: 661-288-4800
  • Fax:
Mailing address:
  • Phone: 661-288-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number26660
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: