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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 5 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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