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General NPI Number Information
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NPI Number | 1124985155
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Entity Type | Organization
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Legal Business Name | KATE DIASAMIDZE PSYD PSYCHOLOGY PC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 15260 VENTURA BLVD STE 1200
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City | SHERMAN OAKS
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State | CA
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Zip | 91403-5347
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Country | US
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Telephone | 310-717-3191
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Fax |
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Provider Business Mailing Address
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Address Line | 818 W 7TH ST STE 930
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City | LOS ANGELES
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State | CA
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Zip | 90017-3476
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Country | US
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Telephone | 310-717-3191
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | KATE DIASAMIDZE
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Credential | PSY.D.
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Telephone | 310-717-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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