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General NPI Number Information
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NPI Number | 1053836445
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Entity Type | Individual
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Provider Name | JAMES CHARLES HUSEN
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Gender | Male
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Dates
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Enumeration Date | 08/07/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3068 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-2325
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Country | US
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Telephone | 951-314-6634
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Fax | 951-781-8985
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Provider Business Mailing Address
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Address Line | 3068 BROCKTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92501-2325
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Country | US
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Telephone | 951-314-6634
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Fax | 951-781-8985
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC2200X
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Taxonomy Name | Clinical Child & Adolescent Psychologist
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License Number | PSY30102
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number | PSY30102
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 103TF0200X
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Taxonomy Name | Forensic Psychologist
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License Number | PSY30102
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 103TP2701X
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Taxonomy Name | Group Psychotherapy Psychologist
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License Number | PSY30102
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 86502
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License Number State | CA
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Taxonomy #6
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY30102
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License Number State | CA
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