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General NPI Number Information
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NPI Number | 1912636697
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Entity Type | Organization
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Legal Business Name | SASHA KASSAI PSYCHOLOGY INC
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Dates
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Enumeration Date | 06/07/2022
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Last Update Date | 06/07/2022
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Provider Practice Location Address
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Address Line | 3406 VIA LIDO STE 1A377
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3961
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Country | US
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Telephone | 310-985-5846
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Fax |
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Provider Business Mailing Address
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Address Line | 3406 VIA LIDO STE 1A377
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-3961
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Country | US
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Telephone | 310-985-5846
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Fax |
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Authorized Official
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Title or Position | CEO/OWNER
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Name | DR. SHABNAM SASHA KASSAI
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Credential | PSY.D.
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Telephone | 310-985-5846
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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 |
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License Number State |
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