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General NPI Number Information
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NPI Number | 1649557232
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Entity Type | Individual
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Provider Name | JOSEPH JOHNNY KOUDSI PSY.D.
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Gender | Male
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 2970 CAMINO DIABLO STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94597-4001
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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Provider Business Mailing Address
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Address Line | 2970 CAMINO DIABLO STE 300
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City | WALNUT CREEK
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State | CA
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Zip | 94597-4001
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Country | US
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Telephone | 925-282-1778
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Fax | 415-296-5299
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 24646
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License Number State | CA
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