Kussin-Shoptaw, Alexandra Lillian
Kussin-Shoptaw, Alexandra Lillian is an individual health care provider with primary practice located at 13400 Riverside Dr Ste 318 , Sherman Oaks CA 91423-2501. She recently has 6 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Health Service, Student, Health Care / Student in an Organized Health Care Education/Training Program, Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Clinical Child & Adolescent, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Family. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kussin-Shoptaw, Alexandra Lillian can be contacted via phone (323) 418-2103.Contact Information
Primary practice address
13400 Riverside Dr Ste 318
Sherman Oaks CA 91423-2501
Phone: (323) 418-2103
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Health Service | 103TH0100X | PSY30547 | California |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | PSY30547 | California |
| Behavioral Health & Social Service Providers / Clinical Child & Adolescent | 103TC2200X | PSY30547 | California |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | ||
| Behavioral Health & Social Service Providers / Family | 103TF0000X | PSY30547 | California |
Profile Details
| NPI number | 1588952055 |
|---|---|
| LBN Legal business name | Kussin-Shoptaw, Alexandra Lillian |
| Credentials | PHD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 18th, 2011 |
| Last updated | Jul 1st, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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