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General NPI Number Information
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NPI Number | 1508780594
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Entity Type | Organization
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Legal Business Name | VANDER DUSSEN & ASSOCIATES PSYCHOLOGICAL CORPORATION
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 101 S KRAEMER BLVD STE 114
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City | PLACENTIA
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State | CA
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Zip | 92870-6109
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Country | US
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Telephone | 714-329-6080
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Fax |
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Provider Business Mailing Address
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Address Line | 101 S KRAEMER BLVD STE 114
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City | PLACENTIA
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State | CA
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Zip | 92870-6109
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Country | US
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Telephone | 714-329-6080
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KIMBERLY VANDER DUSSEN
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Credential | PSY.D.
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Telephone | 714-329-6080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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